Canton Psychological Services | |
2801 Foster Avenue Baltimore MD 21224-3816 | |
(410) 499-7792 | |
(410) 732-7427 |
Full Name | Canton Psychological Services |
---|---|
Speciality | Psychologist - Clinical |
Location | 2801 Foster Avenue, Baltimore, Maryland |
Authorized Official Name and Position | Patricia J Lackey (PSYCHOLOGIST PRESIDENT) |
Authorized Official Contact | 4104997792 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Canton Psychological Services 13801 York Rd K14 Cockeysville MD 21030-1895 Ph: (410) 499-7792 | Canton Psychological Services 2801 Foster Avenue Baltimore MD 21224-3816 Ph: (410) 499-7792 |
NPI Number | 1588855662 |
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Provider Enumeration Date | 08/05/2007 |
Last Update Date | 08/05/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588855662 | NPI | - | NPPES |
K74 | Other | MD | MD BC AND BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 03096 (Maryland) | Primary |
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