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General NPI Number Information
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NPI Number | 1497973036
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Entity Type | Individual
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Provider Name | DANA LOUISE DE MASO PHD
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 421 PEAR TREE POINT RD
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City | CHESTERTOWN
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State | MD
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Zip | 21620-2342
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Country | US
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Telephone | 425-922-4063
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Fax |
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Provider Business Mailing Address
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Address Line | 2336 GODDARD PKWY
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City | SALISBURY
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State | MD
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Zip | 21801-1126
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Country | US
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Telephone | 410-334-6961
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Fax | 410-334-6362
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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 | LH00007347
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 04716
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 04716
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04716
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License Number State | MD
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