Provider Demographics
NPI:1033406319
Name:FITZPATRICK, STEPHANIE LENAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LENAY
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FLANDERS CT
Mailing Address - Street 2:APT. F
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5149
Mailing Address - Country:US
Mailing Address - Phone:502-345-1476
Mailing Address - Fax:
Practice Address - Street 1:2024 E. MONUMENT ST.
Practice Address - Street 2:SUITE 2-624
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205
Practice Address - Country:US
Practice Address - Phone:410-502-2794
Practice Address - Fax:410-955-0476
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD99999999999999999999103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical