Organization
LAKE LINGANORE PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE SHEILA TATE PMHNP (MANAGER)
(240) 405-8084
Entity
Organization
Contact information
Practice address
617 W PATRICK ST STE 223, FREDERICK, MD 21701-4027
(240) 405-8084
Mailing address
201 E PATRICK ST, FREDERICK, MD 21705-7501
(240) 405-8084
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/04/2023
Last updated
06/11/2024
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