Individual
CAROLINE H POBLETE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3454 ELLICOTT CENTER DR, SUITE 106, ELLICOTT CITY, MD 21043-4113
(410) 461-3760
(410) 461-0526
Mailing address
3454 ELLICOTT CENTER DR, SUITE 106, ELLICOTT CITY, MD 21043-4113
(410) 461-3760
(410) 461-0526
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D45386
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
596105000
—
MD
Enumeration date
09/08/2006
Last updated
06/16/2014
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