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General NPI Number Information
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NPI Number | 1477376085
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Entity Type | Organization
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Legal Business Name | JOANNE BAGSHAW & ASSOCIATES
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Dates
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Enumeration Date | 11/02/2024
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Last Update Date | 11/02/2024
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Provider Practice Location Address
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Address Line | 316 MAIN ST STE 200
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City | GAITHERSBURG
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State | MD
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Zip | 20878-6551
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Country | US
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Telephone | 301-288-3723
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Fax |
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Provider Business Mailing Address
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Address Line | 745 CHESTERTOWN ST
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City | GAITHERSBURG
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State | MD
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Zip | 20878-5755
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Country | US
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Telephone | 631-697-5568
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOANNE BAGSHAW
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Credential | PHD, LCPC
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Telephone | 301-288-3723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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