Provider Demographics
NPI:1063640209
Name:ZAJDEL, RUTH TAMAR (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:TAMAR
Last Name:ZAJDEL
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 1:1812 BALTIMORE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7146
Mailing Address - Country:US
Mailing Address - Phone:410-751-6176
Mailing Address - Fax:410-857-4176
Practice Address - Street 1:1812 BALTIMORE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7146
Practice Address - Country:US
Practice Address - Phone:410-751-6176
Practice Address - Fax:410-857-4176
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04565103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent