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Individual

MRS. MICHELLE RENEE PASTERNACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCSW C

Contact information

Practice address
7130 MINSTREL WAY, SUITE 212, COLUMBIA, MD 21045
(410) 290-6940
(410) 290-9763
Mailing address
120 SISTER PIERRE DRIVE, SUITE 403, TOWSON, MD 21204
(410) 823-6408
(443) 279-0537

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04851
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0016
BSDC INDIVIDUAL
01
002668
VAL INDIVIDUAL
01
150N
MBMD GROUP
01
150N124G
MBMD INDIVIDUAL
01
2139989
MAMS INDIVIDUAL
01
226570
KAIS INDIVIDUAL
01
252450
COMP GROUP
01
253552
COMP INDIVIDUAL
01
331947
MHN INDIVIDUAL
01
360218
MHN GROUP
01
52317109
BSMD INDIVIDUAL
01
705BPS
BSMD GROUP
01
K452
BSDC GROUP
01
PVPB119420
APS INDIVIDUAL
Enumeration date
06/02/2006
Last updated
07/08/2007
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