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General NPI Number Information
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NPI Number | 1568766988
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Entity Type | Individual
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Provider Name | CHARLES WILBERT CURTIS II PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 15000 BROSCHART RD
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City | ROCKVILLE
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State | MD
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Zip | 20850-3303
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Country | US
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Telephone | 301-251-6854
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Fax | 301-251-6831
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Provider Business Mailing Address
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Address Line | PO BOX 60144
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City | WASHINGTON
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State | DC
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Zip | 20039-0144
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Country | US
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Telephone | 804-677-3270
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 04818
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License Number State | MD
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