Organization
FAMILY SERVICE FOUNDATION, INC
Active
Other names
FAMILY SERVICE OF PRINCE GEORGES COUNTY, INC
Organization subpart
No
Provider details
NPI number
Authorized official
DAPHNE SMITH (BILLING MANAGER)
(301) 459-2121
Entity
Organization
Contact information
Practice address
306 DELAWARE ROAD, FREDERICK, MD 21701-4618
(301) 378-0261
(301) 378-0267
Mailing address
5301 76TH AVE, LANDOVER HILLS, MD 20784-1703
(301) 459-2121
(301) 918-9757
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
4163
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320741200
—
MD
Enumeration date
03/18/2010
Last updated
09/19/2012
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