Healthcare Provider Details

I. General information

NPI: 1639528482
Provider Name (Legal Business Name): LOUISA FLYNN PSYD, PMH-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LOUISA CAHN-GAMBINO

II. Dates (important events)

Enumeration Date: 06/11/2016
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 DEFENSE HWY STE 203
ANNAPOLIS MD
21401-8922
US

IV. Provider business mailing address

166 DEFENSE HWY STE 203
ANNAPOLIS MD
21401-8922
US

V. Phone/Fax

Practice location:
  • Phone: 410-684-3806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number07493
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810008801
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: