Organization Name: | ROCHELLE WYNNE AUSTRIAN PH.D.PA |
NPI Number: | 1043335508 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROCHELLE WYNNE AUSTRIAN (PRESIDENT) |
Mailing Address: | 981 Russell Ave Gaithersburg |
State: | MD US |
Postal Code: | 208796219 |
Phone Number: | 3018401723 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 01431 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |