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General NPI Number Information
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NPI Number | 1548349822
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Entity Type | Individual
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Provider Name | PATRICIA NOWICKI THOMPSON PHD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 1645 LIBERTY ROAD SUITE 104
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City | ELDERSBURG
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State | MD
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Zip | 21784
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Country | US
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Telephone | 410-795-4764
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Fax | 410-795-4462
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Provider Business Mailing Address
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Address Line | 3723 BIRCHMERE CT
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City | OWINGS MILLS
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State | MD
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Zip | 21117-1298
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Country | US
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Telephone | 443-286-1107
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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 | 002867
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License Number State | MD
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