| NPI | 1982350674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA C SCUDJOREK Owner/Provider 410-575-3061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2024-03-01 |