Provider Demographics
NPI:1508194499
Name:WALDSTEIN, SHARI RUTH (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:RUTH
Last Name:WALDSTEIN
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 1:220 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5611
Mailing Address - Country:US
Mailing Address - Phone:410-719-7170
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PSYCHOLOGY UMBC
Practice Address - Street 2:1000 HILLTOP CIRCLE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21250-0001
Practice Address - Country:US
Practice Address - Phone:410-455-2374
Practice Address - Fax:410-455-1055
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03230103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical