Healthcare Provider Details

I. General information

NPI: 1235801747
Provider Name (Legal Business Name): EMILY NAVEIRA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2021
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 N WOLFE ST
BALTIMORE MD
21205-1113
US

IV. Provider business mailing address

933 N WOLFE ST
BALTIMORE MD
21205-1113
US

V. Phone/Fax

Practice location:
  • Phone: 410-516-3311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number07301
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: