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General NPI Number Information
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NPI Number | 1720940513
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Entity Type | Individual
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Provider Name | OLIVIA SMITH-ELNAGGAR MITSOS PSYD, MA
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2110 PRIEST BRIDGE DR STE 1
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City | CROFTON
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State | MD
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Zip | 21114-2472
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Country | US
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Telephone | 443-937-7089
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Fax | 443-292-4570
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Provider Business Mailing Address
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Address Line | 2110 PRIEST BRIDGE DR STE 1
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City | CROFTON
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State | MD
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Zip | 21114-2472
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Country | US
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Telephone | 443-937-7089
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Fax | 443-292-4570
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | A01277
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License Number State | MD
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