| NPI | 1972829885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA W ASHBAUGH Owner 410-905-1092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003067) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2011-06-01 |