| NPI | 1952800237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVETTE GRIFFIN Director Of Operations 443-221-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC7097) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC7194) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R144895) | |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-02-01 |