| NPI | 1982436317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA REPAC CFO 301-790-9351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |