Individual
DR. STEFANIE ALISON MOYNIHAN KYDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
220 BOWEN CT, ANNAPOLIS, MD 21401-1945
(617) 943-9640
Mailing address
220 BOWEN CT, ANNAPOLIS, MD 21401-1945
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
07009
MD
103TC0700X
Clinical Psychologist
LP03048
KS
103TC0700X
Clinical Psychologist
Primary
PY61149309
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11870
ASPPB E.PASSPORT/APIT MOBILITY NUMBER
—
01
—
TPPY1243
OUT-OF-STATE TELEHEALTH PROVIDER REGISTRATION
FL
Enumeration date
09/01/2021
Last updated
08/25/2023
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