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General NPI Number Information
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NPI Number | 1386768372
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Entity Type | Individual
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Provider Name | PAULINE PRINCE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1110 BENFIELD BLVD SUITE J-FRONT
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2540
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Country | US
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Telephone | 410-693-8431
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Fax |
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Provider Business Mailing Address
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Address Line | 264 CONSTANT AVE
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City | SEVERN
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State | MD
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Zip | 21144-3403
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Country | US
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Telephone | 410-693-8431
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3160
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License Number State | MD
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