Organization
REGINALD S LOURIE CENTER FOR INFANTS & YOUNG CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACYE A POLSON LCSWC (EXECUTIVE DIRECTOR)
(301) 984-4444
Entity
Organization
Contact information
Practice address
12301 ACADEMY WAY, ROCKVILLE, MD 20852-2000
(301) 984-4444
(301) 881-8073
Mailing address
12301 ACADEMY WAY, ROCKVILLE, MD 20852-2000
(301) 984-4444
(301) 881-8073
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
11020
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266561100
—
MD
Enumeration date
05/18/2006
Last updated
05/01/2008
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