Healthcare Provider Details

I. General information

NPI: 1760814297
Provider Name (Legal Business Name): SARAH WEDEN PSY.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8160 MAPLE LAWN BLVD SUITE 200
FULTON MD
20759-2615
US

IV. Provider business mailing address

8160 MAPLE LAWN BLVD SUITE 200
FULTON MD
20759-2615
US

V. Phone/Fax

Practice location:
  • Phone: 443-212-8378
  • Fax: 443-288-6787
Mailing address:
  • Phone: 443-212-8378
  • Fax: 443-288-6787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SARAH KIM WEDEN
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 443-212-8378