Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 03921 | MD |
NPI | 1124248810 |
---|---|
Provider Name | Helena O. Jareb |
First Address | Silver Spring, MD 20910-4114 |
Second Address | Silver Spring, MD 20910-4114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
710A HO | BCBS MD RENDERING # (01) | MD |
K840 0001 | BCBS PROVIDER # (01) | MD |