Provider Demographics
NPI:1518237056
Name:NEUROPSYCHOLOGY CENTER OF MARYLAND LLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY CENTER OF MARYLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:N
Authorized Official - Last Name:JUNI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-379-0033
Mailing Address - Street 1:2501 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2505
Mailing Address - Country:US
Mailing Address - Phone:443-379-0033
Mailing Address - Fax:443-213-1502
Practice Address - Street 1:2501 SMITH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2505
Practice Address - Country:US
Practice Address - Phone:443-379-0033
Practice Address - Fax:443-213-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04651103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty