Individual
DR. BEN FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4843 LANGDRUM LN, CHEVY CHASE, MD 20815-5412
(301) 986-0626
Mailing address
4843 LANGDRUM LN, CHEVY CHASE, MD 20815-5412
(301) 986-0626
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2249
MD
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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