Individual
DOUGLAS A FREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
10 W MADISON ST STE 11, BALTIMORE, MD 21201-2313
(443) 438-7863
Mailing address
10 W MADISON ST STE 11, BALTIMORE, MD 21201-2313
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05970
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039188300
—
MD
05
—
052304600
—
MD
05
—
086453600
—
MD
05
—
225209100
—
MD
05
—
258013600
—
MD
05
—
693205300
—
MD
05
—
873305800
—
MD
Enumeration date
02/26/2018
Last updated
02/26/2018
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