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General NPI Number Information
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NPI Number | 1275266058
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Entity Type | Organization
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Legal Business Name | MARIA JOSE RENDON PH.D. LLC
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 12712 DEEP SPRING DR
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City | POTOMAC
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State | MD
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Zip | 20854-2355
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Country | US
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Telephone | 240-200-0842
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Fax | 301-590-0758
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Provider Business Mailing Address
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Address Line | 402 KING FARM BLVD SUITE 125, #1102
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 786-281-4742
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. MARIA JOSE RENDON
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Credential | PH.D.
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Telephone | 240-200-0842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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