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General NPI Number Information
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NPI Number | 1922877075
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Entity Type | Organization
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Legal Business Name | THE EDUCATIONAL RESOURCE GROUP
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Dates
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Enumeration Date | 12/29/2023
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 570 BENFIELD RD
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City | SEVERNA PARK
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State | MD
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Zip | 21146-2530
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Country | US
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Telephone | 410-544-6696
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Fax |
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Provider Business Mailing Address
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Address Line | 570 BENFIELD RD
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City | SEVERNA PARK
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State | MD
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Zip | 21146-2530
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Country | US
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Telephone | 410-544-6696
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | NITHIN KRISHNA
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Credential | MD
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Telephone | 410-544-6696
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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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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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