Provider Demographics
NPI:1750422770
Name:FOEHLINGER, GROVER C JR (PHD)
Entity type:Individual
Prefix:DR
First Name:GROVER
Middle Name:C
Last Name:FOEHLINGER
Suffix:JR
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 1:5821 IVY LEAGUE DR
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5375
Mailing Address - Country:US
Mailing Address - Phone:571-480-8777
Mailing Address - Fax:443-451-2689
Practice Address - Street 1:5821 IVY LEAGUE DR
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5375
Practice Address - Country:US
Practice Address - Phone:571-480-8777
Practice Address - Fax:443-451-2689
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17678103T00000X
DEB1-0000383103T00000X
MD02811103T00000X
VA0803000091103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool