Individual
DR. TIFFANY BRUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10440 SHAKER DR, COLUMBIA, MD 21046-1200
(347) 392-0732
Mailing address
8207 FEATHERHILL RD APT 303, PERRY HALL, MD 21128-9224
(347) 392-0732
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
06135
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06134
BOARD OF PSYCHOLOGY
MD
Enumeration date
07/04/2019
Last updated
07/04/2019
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