Healthcare Provider Details

I. General information

NPI: 1174492714
Provider Name (Legal Business Name): JESSICA REICH ZINDER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 RIDGELY AVE
ANNAPOLIS MD
21401-1069
US

IV. Provider business mailing address

406 KINGS COLLEGE DR
ARNOLD MD
21012-1831
US

V. Phone/Fax

Practice location:
  • Phone: 410-440-1117
  • Fax:
Mailing address:
  • Phone: 410-440-1117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number07475
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: