Provider Demographics
NPI:1932471570
Name:SAVAGE, VERNON THOMAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:THOMAS
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9605 MENDOZA RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2502
Mailing Address - Country:US
Mailing Address - Phone:410-655-0183
Mailing Address - Fax:
Practice Address - Street 1:20 CROSSROADS DR
Practice Address - Street 2:SUIT 104
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5419
Practice Address - Country:US
Practice Address - Phone:410-655-0183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-28
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02490103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist