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General NPI Number Information
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NPI Number | 1669001590
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Entity Type | Organization
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Legal Business Name | SALLY G. MCBRIDE PH.D.
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 705 AMERICANA DR APT 35
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City | ANNAPOLIS
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State | MD
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Zip | 21403-3186
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Country | US
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Telephone | 443-223-9002
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 BAY RIDGE AVE # 119
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City | ANNAPOLIS
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State | MD
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Zip | 21403-3031
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Country | US
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Telephone | 443-223-9002
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE OFFICER
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Name | SALLY G MCBRIDE
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Credential | PH D
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Telephone | 443-223-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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