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General NPI Number Information
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NPI Number | 1366461014
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Entity Type | Individual
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Provider Name | GARY A CURTIS PHD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 1407 YORK RD SUITE309
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City | LUTHERVILLE
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State | MD
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Zip | 21093-6097
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Country | US
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Telephone | 410-825-2281
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Fax | 410-825-0757
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Provider Business Mailing Address
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Address Line | PO BOX 998
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City | CHURCHVILLE
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State | VA
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Zip | 24421-0900
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Country | US
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Telephone | 410-825-2281
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Fax | 410-825-0757
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 03714
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 3714
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810003695
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License Number State | VA
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