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General NPI Number Information
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NPI Number | 1043727928
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Entity Type | Individual
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Provider Name | DANIELLE SAURO VIRGADAMO PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/02/2018
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 1741 ASHLAND AVE
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City | BALTIMORE
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State | MD
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Zip | 21205-1531
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Country | US
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Telephone | 609-501-2458
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 WHITE AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-3436
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 022513
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License Number State | NY
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