Organization
COQUUS
Active
Other names
Vance Mental Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA VANCE PH.D. (DIRECTOR)
(301) 848-0461
Entity
Organization
Contact information
Practice address
21 INDUSTRIAL PARK DR, SUITE 202 F, WALDORF, MD 20602-2751
(301) 848-0461
(301) 885-0922
Mailing address
21 INDUSTRIAL PARK DR, SUITE 202 F, WALDORF, MD 20602-2751
(301) 848-0461
(301) 885-0922
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
02983
MD
1041C0700X
Clinical Social Worker
05567
MD
Other
Enumeration date
04/14/2009
Last updated
06/24/2009
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