Organization
CORE CLINICAL SERVICES
Active
Organization
CORE CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARQUERITE PETRANELLA LABAN PHD (OWNER)
(410) 371-7187
Entity
Organization
Contact information
Practice address
9475 DEERECO RD, SUITE 410, TIMONIUM, MD 21093-2118
(410) 560-6135
(410) 560-6136
Mailing address
9475 DEERECO RD, SUITE 410, TIMONIUM, MD 21093-2118
(410) 560-6135
(410) 560-6136
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05420
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
717002500
—
MD
Enumeration date
08/10/2015
Last updated
08/08/2023
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