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7604 Vicar Pl New Carrollton MD 20784-2966 | |
| (202) 823-9346 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist - Adult Development & Aging |
| Location | 7604 Vicar Pl, New Carrollton, Maryland |
| Authorized Official Name and Position | Andrea K Rodney (CEO) |
| Authorized Official Contact | 2028239346 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7604 Vicar Pl New Carrollton MD 20784-2966 Ph: (202) 823-9346 | 7604 Vicar Pl New Carrollton MD 20784-2966 Ph: (202) 823-9346 |
| NPI Number | 1750021614 |
|---|---|
| Provider Enumeration Date | 03/30/2022 |
| Last Update Date | 04/07/2022 |
| Certification Date | 04/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750021614 | NPI | - | NPPES |
| W20782660 | Other | MD | OTHER LOCATIONS LICENSED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0700X | Psychologist - Adult Development & Aging | (* (Not Available)) | Primary |
| 282J00000X | Religious Nonmedical Health Care Institution | (* (Not Available)) | Secondary |
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