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Organization

SAND R. BAGOON, PH.D., PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAND ROYCE BAGOON PH.D. (LICENSED PSYCHOLOGIST)
(410) 781-7263
Entity
Organization

Contact information

Practice address
3355 SAINT JOHNS LN, SUITE F, ELLICOTT CITY, MD 21042-2605
(410) 781-7263
Mailing address
1263 GUILFORD RD, ELDERSBURG, MD 21784-8862
(410) 781-7263

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
02686
MD

Other

Enumeration date
02/05/2011
Last updated
02/05/2011
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