Individual
IFIGENIA MOUGIANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1750 E FAIRMOUNT AVE, BALTIMORE, MD 21231-1534
(617) 665-1183
(617) 665-3449
Mailing address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-4587
(443) 923-4587
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
10950
MA
103TH0100X
Health Service Psychologist
Primary
10950
MA
103TP2701X
Group Psychotherapy Psychologist
10950
MA
Other
Enumeration date
04/20/2017
Last updated
12/19/2019
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