| NPI | 1972954824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATELYN TRENTALANGE Director 410-370-8637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 16625) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2021-08-03 |