Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R179087 | MD |
NPI | 1023621174 |
---|---|
Provider Name | Mrs. Wendy Strong |
First Address | Aberdeen, MD 21001-3940 |
Second Address | Columbia, MD 21045-2370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2020 |
Last Update Date | 28/08/2020 |