Organization
CATHRYNE L. MACIOLEK, PSY.D., LLC
Active
Other names
The Mandala Center: Behavioral Health & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHRYNE L MACIOLEK PSY.D. (PRINCIPAL)
(410) 591-5380
Entity
Organization
Contact information
Practice address
540 E. BELVEDERE AVENUE, SUITE 203, BALTIMORE, MD 21212
(410) 591-5380
Mailing address
540 E BELVEDERE AVE, SUITE 203, BALTIMORE, MD 21212-3750
(410) 591-5380
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05298
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
393635
MEDICARE PTAN
—
Enumeration date
02/25/2015
Last updated
12/02/2015
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