Healthcare Provider Details

I. General information

NPI: 1710207568
Provider Name (Legal Business Name): SARAH K. LOVE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 OLANDWOOD COURT, SUITE 202
OLNEY MD
20832
US

IV. Provider business mailing address

3415 OLANDWOOD COURT, SUITE 202
OLNEY MD
20832
US

V. Phone/Fax

Practice location:
  • Phone: 301-456-5589
  • Fax: 301-294-7569
Mailing address:
  • Phone: 301-456-5589
  • Fax: 301-309-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number05397
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: