Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 04889 | MD |
NPI | 1023374816 |
---|---|
Provider Name | Dr. Heather Rose Loffredo |
First Address | Silver Spring, MD 20904-2606 |
Second Address | Silver Spring, MD 20904-2606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 25/02/2016 |