Organization
JAIME FENTON, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIME FENTON PH.D, LLC (PSYCHOLOGIST)
(443) 602-6426
Entity
Organization
Contact information
Practice address
405 ALLEGHENY AVE, TOWSON, MD 21204-4256
(443) 602-6426
Mailing address
405 ALLEGHENY AVE, TOWSON, MD 21204-4256
(443) 602-6426
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4435
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366891806
NPI
MD
Enumeration date
09/21/2016
Last updated
09/21/2016
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