| NPI | 1942728175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENNADY VINOKUR Practice Administrator 301-330-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2022-07-21 |