Provider Demographics
NPI:1518082478
Name:VANCE, PATRICIA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:VANCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:VANCE
Other - Last Name:SCHMITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 INDUSTRIAL PARK DR
Mailing Address - Street 2:SUITE 202 F
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2751
Mailing Address - Country:US
Mailing Address - Phone:301-848-0461
Mailing Address - Fax:301-885-0922
Practice Address - Street 1:21 INDUSTRIAL PARK DR
Practice Address - Street 2:SUITE 202 F
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2751
Practice Address - Country:US
Practice Address - Phone:301-848-0461
Practice Address - Fax:301-885-0922
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02983103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist