| NPI | 1982279253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A TUCKER-JONES Owner/Member 410-216-0268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |