Provider Demographics
NPI:1508067448
Name:GARTNER, ALISON ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:ANNE
Last Name:GARTNER
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 1:6525 N CHARLES ST
Mailing Address - Street 2:SUITE 143
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6872
Mailing Address - Country:US
Mailing Address - Phone:410-337-2520
Mailing Address - Fax:410-938-4444
Practice Address - Street 1:6525 N CHARLES ST
Practice Address - Street 2:SUITE 143
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6872
Practice Address - Country:US
Practice Address - Phone:410-337-2520
Practice Address - Fax:410-938-4444
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2251103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical