Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TS0200X | School Psychologist | 04803 | MD |
Y | 103TS0200X | School Psychologist | 2994 | GA |
NPI | 1073737698 |
---|---|
Provider Name | Dr. Jennifer Thorpe |
First Address | Severna Park, MD 21146-4648 |
Second Address | Severna Park, MD 21146-3915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 17/04/2012 |