Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 03272 | MD |
Y | 103TC0700X | Clinical Psychologist | 03272 | MD |
NPI | 1013129337 |
---|---|
Provider Name | Michael J Priester |
First Address | Baltimore, MD 21204-6819 |
Second Address | Baltimore, MD 21204-6819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |