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Individual

NELSON G BENTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
204 E JOPPA ROAD PH16, TOWSON, MD 21286
(410) 337-9441
(410) 339-7169
Mailing address
602 LAKE DRIVE, TOWSON, MD 21286
(410) 583-7256

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01720
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00874
VALUE OPTIONS
01
221724
COMPSYCH
01
24097
JOHN HOPKINS EHP
01
245893
MAMSI
01
58050001
CARE FIRST BCBS
MD
01
6148825
UNITED BEHAVIORAL HEALTH
Enumeration date
11/30/2006
Last updated
07/08/2007
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