Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 05455 | MD |
Y | 103TC0700X | Clinical Psychologist | 05455 | MD |
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1669728168 |
---|---|
Provider Name | Dr. Megan Hosey Mastalerz |
First Address | Baltimore, MD 21287 |
Second Address | Baltimore, MD 21287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2012 |
Last Update Date | 10/06/2019 |