Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 03345 | MD |
Y | 103T00000X | Psychologist | 03345 | MD |
NPI | 1013999390 |
---|---|
Provider Name | Edda Natanya Weissberg |
First Address | Arnold, MD 21012-2742 |
Second Address | Annapolis, MD 21401-3854 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 08/07/2007 |