MEDICARE: CECILIA ROWLAND EDD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	002211	CT
2	103TC0700X	Clinical Psychologist	PSY1001218	DC

General Provider Information

NPI Number	:	1609810498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA ROWLAND EDD

Provider Business Mailing Address
First Line	:	PO BOX 37215
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-3215
Country	:	US
Telephone Number	:	202-476-5000
Fax Number	:	301-244-6301

Provider Business Practice Location Address
First Line	:	2101 MARTIN LUTHER KING JR AVE SE
Second Line	:	CHILDRENS HEALTH CLINIC ANACOSTIA
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5702
Country	:	US
Telephone Number	:	202-476-6900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	01/25/2017

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