Provider Demographics
NPI:1952616195
Name:LAGOR, ANNE (PSYD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:LAGOR
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 1:100 HELFEN BEIN LN
Mailing Address - Street 2:STE 230D
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2653
Mailing Address - Country:US
Mailing Address - Phone:410-604-0226
Mailing Address - Fax:877-643-0126
Practice Address - Street 1:100 HELFEN BEIN LN
Practice Address - Street 2:STE 230D
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2653
Practice Address - Country:US
Practice Address - Phone:410-604-0226
Practice Address - Fax:877-643-0126
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05284103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical