Healthcare Provider Details

I. General information

NPI: 1124842265
Provider Name (Legal Business Name): MRS. SONALIKA SAXENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E NORTH AVE
BALTIMORE MD
21202-5984
US

IV. Provider business mailing address

9632 EAVES DR
OWINGS MILLS MD
21117-5918
US

V. Phone/Fax

Practice location:
  • Phone: 443-984-2000
  • Fax:
Mailing address:
  • Phone: 443-928-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberCER-77804-Q7Z6Q0
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: