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General NPI Number Information
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NPI Number | 1750685038
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Entity Type | Individual
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Provider Name | RANON CORTELL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/31/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 7555 WATERLOO RD
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City | JESSUP
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State | MD
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Zip | 20794-9783
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Country | US
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Telephone | 410-799-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 817 HYDE RD
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City | SILVER SPRING
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State | MD
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Zip | 20902-3047
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Country | US
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Telephone | 301-593-6015
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04968
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License Number State | MD
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