Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 4882460 | MD |
NPI | 1245645514 |
---|---|
Provider Name | Marie Woods |
First Address | Baltimore, MD 21231-1712 |
Second Address | Baltimore, MD 21231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2014 |
Last Update Date | 25/06/2014 |