Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YM0800X | Mental Health Counselor | ||
N | 103K00000X | Behavior Analyst | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TR0400X | Rehabilitation Psychologist | ||
N | 225C00000X | Rehabilitation Counselor | ||
N | 225CX0006X | Orientation and Mobility Training Provider | ||
N | 225XM0800X | Mental Health |
NPI | 1225789076 |
---|---|
Provider Name | Gloria Denise Dent |
First Address | Severn, MD 21144-6826 |
Second Address | Severn, MD 21144-6826 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2022 |
Last Update Date | 13/01/2022 |