Provider Demographics
NPI:1790911840
Name:STINCHCOMB, DANIEL C
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:C
Last Name:STINCHCOMB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7178 COLUMBIA GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2581
Mailing Address - Country:US
Mailing Address - Phone:410-313-6202
Mailing Address - Fax:410-313-6212
Practice Address - Street 1:7178 COLUMBIA GATEWAY DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2581
Practice Address - Country:US
Practice Address - Phone:410-313-6202
Practice Address - Fax:410-313-6212
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0304101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional