Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | MD | |
Y | 103T00000X | Psychologist | MD | |
N | 103TB0200X | Cognitive & Behavioral Psychologist | MD | |
N | 103TS0200X | School Psychologist | MD |
NPI | 1154824605 |
---|---|
Provider Name | Dr. Laura Groft |
First Address | Brookeville, MD 20833-3251 |
Second Address | Millersville, MD 21108-2645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2018 |
Last Update Date | 12/03/2018 |