Organization
TARA ACEVEDO, PSY.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA ACEVEDO PSY.D. (EXECUTIVE DIRECTOR)
(610) 217-0821
Entity
Organization
Contact information
Practice address
6213 DEEP EARTH LN, COLUMBIA, MD 21045-2565
(610) 217-0821
Mailing address
6213 DEEP EARTH LN, COLUMBIA, MD 21045-2565
(610) 217-0821
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05587
MD
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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