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General NPI Number Information
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NPI Number | 1144926692
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Entity Type | Individual
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Provider Name | TIMOTHY G AYD LGPC
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Gender | Male
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 10440 SHAKER DR STE 207
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City | COLUMBIA
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State | MD
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Zip | 21046-2339
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Country | US
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Telephone | 443-372-8169
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Fax |
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Provider Business Mailing Address
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Address Line | 312 SPRY ISLAND RD
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City | JOPPA
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State | MD
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Zip | 21085-5424
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Country | US
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Telephone | 443-910-2831
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP13550
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License Number State | MD
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