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General NPI Number Information
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NPI Number | 1851042881
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Entity Type | Organization
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Legal Business Name | FOSTER PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 701 S CONKLING ST STE B
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City | BALTIMORE
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State | MD
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Zip | 21224-4302
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Country | US
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Telephone | 240-847-4162
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 FOSTER AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-4334
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Country | US
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Telephone | 240-672-2459
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. MEGAN NORMAN
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Credential | PSY.D.
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Telephone | 240-847-4162
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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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