Healthcare Provider Details

I. General information

NPI: 1710106323
Provider Name (Legal Business Name): RICHARD LESLIE OGDEN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 EAST-WEST HWY SUITE 1028
BETHESDA MD
20814-4524
US

IV. Provider business mailing address

11112 WAYCROFT WAY
ROCKVILLE MD
20852-3217
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-5499
  • Fax: 301-907-3241
Mailing address:
  • Phone: 301-537-7570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number01297
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: