Organization
PSYCHOTHERAPEUTIC SERVICES OF SOUTHERN MARYLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL COOPER CPA (CHIEF FINANCIAL OFFICER)
(410) 778-9114
Entity
Organization
Contact information
Practice address
105 PAUL MELLON CT, SUITE 19, 20, WALDORF, MD 20602-2762
(301) 638-7787
(301) 638-7768
Mailing address
PO BOX 690, CHESTERTOWN, MD 21620-0690
(410) 778-9114
(410) 778-7988
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
11/15/2006
Last updated
08/22/2020
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