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Individual

VIRGINIA SAMFORD HORNBECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1400 W COLD SPRING LN, BALTIMORE, MD 21209-4904
(410) 591-3912
Mailing address
708 SAINT JOHNS RD, BALTIMORE, MD 21210-2134
(410) 433-7628

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
04415
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04415
STATE OF MD, DEPT OF HEALTH
MD
Enumeration date
06/04/2019
Last updated
06/04/2019
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