| Baltimore County | |
|
1300 York Rd Suite 149 Lutherville MD 21093-6016 | |
| (410) 823-7784 | |
| (410) 823-7633 |
| Full Name | Baltimore County |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 1300 York Rd, Lutherville, Maryland |
| Authorized Official Name and Position | Randall Cooper (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4107789114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baltimore County Po Box 690 Chestertown MD 21620-0690 Ph: (410) 778-9114 | Baltimore County 1300 York Rd Suite 149 Lutherville MD 21093-6016 Ph: (410) 823-7784 |
| NPI Number | 1477628592 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477628592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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