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General NPI Number Information
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NPI Number | 1053703298
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Entity Type | Organization
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Legal Business Name | CATHRYNE L. MACIOLEK, PSY.D., LLC
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Dates
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Enumeration Date | 02/25/2015
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 540 E. BELVEDERE AVENUE SUITE 203
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City | BALTIMORE
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State | MD
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Zip | 21212
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Country | US
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Telephone | 410-591-5380
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Fax |
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Provider Business Mailing Address
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Address Line | 540 E BELVEDERE AVE SUITE 203
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City | BALTIMORE
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State | MD
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Zip | 21212-3750
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Country | US
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Telephone | 410-591-5380
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | DR. CATHRYNE L MACIOLEK
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Credential | PSY.D.
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Telephone | 410-591-5380
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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 | 05298
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License Number State | MD
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