Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 651 | MD |
N | 103T00000X | Psychologist | 651 | MD |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | 651 | MD |
N | 103TC0700X | Clinical Psychologist | 651 | MD |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1811039068 |
---|---|
Provider Name | Dr. John C Rhead |
First Address | Columbia, MD 21044-2601 |
Second Address | Columbia, MD 21044-2601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12522 | NATIONAL REGISTER (01) |