Healthcare Provider Details

I. General information

NPI: 1932126760
Provider Name (Legal Business Name): MPB GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 SANTIAGO RD STE 11
COLUMBIA MD
21045-3960
US

IV. Provider business mailing address

9650 SANTIAGO RD STE 11
COLUMBIA MD
21045-3960
US

V. Phone/Fax

Practice location:
  • Phone: 410-730-4807
  • Fax: 410-730-2385
Mailing address:
  • Phone: 410-730-4807
  • Fax: 410-730-2385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MAGALIE PIOU-BREWER
Title or Position: CEO/CLINICAL EXEC. DIRECTOR
Credential: LCPC
Phone: 41073048078