Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 05911 | MD |
Y | 103T00000X | Psychologist | 05911 | MD |
NPI | 1013436872 |
---|---|
Provider Name | Dr. Caitlin C Thompson |
First Address | Baltimore, MD 21224-2220 |
Second Address | Columbia, MD 21046-1595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2017 |
Last Update Date | 17/03/2018 |