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Individual

DONALD ALBERT CARLSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH D

Contact information

Practice address
22 EAST 2ND STREET, FREDERICK, MD 21701
(240) 344-4119
Mailing address
22 EAST 2ND STREET, FREDERICK, MD 21701
(240) 344-4119

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3887
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004443100
MD
Enumeration date
07/31/2006
Last updated
05/09/2008
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