Individual
ANNA CRISOLOGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
12301 ACADEMY WAY, ROCKVILLE, MD 20852-2000
(301) 984-4444
(301) 315-3728
Mailing address
12301 ACADEMY WAY, ROCKVILLE, MD 20850
(301) 984-4444
(301) 315-3728
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
05677
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05677
LICENSE
MD
Enumeration date
11/08/2016
Last updated
11/08/2016
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