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General NPI Number Information
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NPI Number | 1811521156
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Entity Type | Organization
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Legal Business Name | PURPOSEFUL ASSESSMENT, CONSULTATION, AND TRAINING, LLC
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 03/29/2020
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Provider Practice Location Address
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Address Line | 3261 OLD WASHINGTON RD STE 2020
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City | WALDORF
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State | MD
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Zip | 20602-3231
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Country | US
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Telephone | 443-873-0835
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Fax |
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Provider Business Mailing Address
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Address Line | 411 WARFIELD DR APT 4012
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City | LANDOVER
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State | MD
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Zip | 20785-5529
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Country | US
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Telephone | 443-873-0835
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | SHALENA L HEARD
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Credential | PH.D.
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Telephone | 443-873-0835
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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 |
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License Number State |
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