Healthcare Provider Details

I. General information

NPI: 1780217323
Provider Name (Legal Business Name): CHRISTIAN HUNT ARBOGAST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 OLD SOLOMONS ISLAND RD
ANNAPOLIS MD
21401-3845
US

IV. Provider business mailing address

2421 CHELMSFORD DR
CROFTON MD
21114-1680
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-4600
  • Fax:
Mailing address:
  • Phone: 410-897-2826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP9899
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: