Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | ||
N | 103TC0700X | Clinical Psychologist | ||
N | 103G00000X | Clinical Psychologist | 04811 | MD |
N | 103TC0700X | Clinical Psychologist | 04811 | MD |
Y | 103TR0400X | Rehabilitation Psychologist | 04811 | MD |
NPI | 1386873271 |
---|---|
Provider Name | Dr. Anna V. Agranovich |
First Address | Baltimore, MD 21287-0001 |
Second Address | Baltimore, MD 21287-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2009 |
Last Update Date | 18/12/2020 |