Healthcare Provider Details

I. General information

NPI: 1457904328
Provider Name (Legal Business Name): PAYTON KLINGENSMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HARRY S TRUMAN PKWY
ANNAPOLIS MD
21401-7580
US

IV. Provider business mailing address

1500 S DOUGLAS RD STE 230
CORAL GABLES FL
33134-4108
US

V. Phone/Fax

Practice location:
  • Phone: 844-244-1818
  • Fax:
Mailing address:
  • Phone: 844-244-1818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: