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Individual

DR. LEO F FENZEL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
28 ALLEGHENY AVE, SUITE 1208, TOWSON, MD 21204-3909
(410) 617-2640
(410) 617-5097
Mailing address
28 ALLEGHENY AVE, SUITE 1208, TOWSON, MD 21204-3909
(410) 617-2640
(410) 617-5097

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
02810
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02810
PSYCHOLOGIST LICENSE
MD
Enumeration date
11/01/2006
Last updated
07/08/2007
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