Provider Demographics
NPI:1669687109
Name:CORONADO, SABINA F (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SABINA
Middle Name:F
Last Name:CORONADO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 FORT MEADE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2040
Mailing Address - Country:US
Mailing Address - Phone:301-317-8100
Mailing Address - Fax:301-317-0118
Practice Address - Street 1:3450 FORT MEADE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2040
Practice Address - Country:US
Practice Address - Phone:301-317-8100
Practice Address - Fax:301-317-0118
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03625103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical