Organization
BAY REGION PSYCHIATRIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANNE C DENTON (PRACTICE MANAGER)
(410) 931-9280
Entity
Organization
Contact information
Practice address
5024 CAMPBELL BLVD, SUITE H, BALTIMORE, MD 21236-5974
(410) 931-9280
(410) 931-6694
Mailing address
5024 CAMPBELL BLVD, SUITE H, BALTIMORE, MD 21236-5974
(410) 931-9280
(410) 931-6694
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154100500
—
MD
05
—
187250800
—
MD
Enumeration date
10/23/2007
Last updated
09/15/2008
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