Organization
SAND R. BAGOON, PH.D., PA
Active
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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