Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 04920 | MD |
Y | 103TC0700X | Clinical Psychologist | 04920 | MD |
NPI | 1003155870 |
---|---|
Provider Name | Sandra Lashley |
First Address | Eldersburg, MD 21784-6464 |
Second Address | Eldersburg, MD 21784-6464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2013 |
Last Update Date | 13/02/2013 |