Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 03945 | MD |
N | 103K00000X | Behavior Analyst | 03945 | MD |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 03945 | MD |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 03945 | MD |
N | 103TM1800X | Intellectual & Developmental Disabilities | 03945 | MD |
NPI | 1104945070 |
---|---|
Provider Name | Dr. Geeta S Sarphare |
First Address | Burtonsville, MD 20866-6120 |
Second Address | Burtonsville, MD 20866-6120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 07/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
780063 | (05) | MD |