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General NPI Number Information
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NPI Number | 1912051210
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Entity Type | Organization
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Legal Business Name | HARVEY L GEWANTER PHD AND ASSOCIATES
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 6918 RIDGE RD
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City | BALTIMORE
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State | MD
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Zip | 21237-3854
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Country | US
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Telephone | 410-764-8209
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Fax |
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Provider Business Mailing Address
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Address Line | 6918 RIDGE RD
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City | BALTIMORE
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State | MD
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Zip | 21237-3854
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Country | US
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Telephone | 410-764-8209
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HARVEY GEWANTER
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Credential | PHD
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Telephone | 410-764-8209
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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 | 02663
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License Number State | MD
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