Healthcare Provider Details

I. General information

NPI: 1649169228
Provider Name (Legal Business Name): ERICK CHRISTOPHER GUZMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 REVOLUTION ST
HAVRE DE GRACE MD
21078-3718
US

IV. Provider business mailing address

4974 BRISTLE CONE CIR
ABERDEEN MD
21001-2604
US

V. Phone/Fax

Practice location:
  • Phone: 410-919-9665
  • Fax:
Mailing address:
  • Phone: 410-493-2205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number07473
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: