KENDEL WYLIE-PUGH


Address: 4309 Travancore Ct, Randallstown, MD 21133-1315
Phone: 4434139484

KENDEL WYLIE-PUGH (NPI# 1992122923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992122923
Entity Type Individual
Full Name KENDEL WYLIE-PUGH
Practice Address 4309 Travancore Ct
Randallstown
MD 21133-1315
Practice Telephone 4434139484
Practice Fax Number 4434310902
Mailing Telephone 4434139484
Mailing Fax Number 4434310902
Enumeration Date 2014-03-27
Last Update Date 2014-03-27
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC2200X Psychologist
Specialization: Clinical Child & Adolescent
PSY1000718 DC Behavioral Health & Social Service Providers

Office Location

Street Address 4309 TRAVANCORE CT
City RANDALLSTOWN
State MD
Zip Code 21133-1315

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1497274880 Yushika M Shepherd In Home Supportive Care 8911 Allenswood Rd, Randallstown, MD 21133 2017-09-17
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1982136198 Marla Rosanne Yee Dentist 5415 Old Court Road, Suite 01, Randallstown, MD 21133 2017-03-28
1598203549 Traci Harris Social Worker 9633 Liberty Rd. (suites H&j), Randallstown, MD 21133 2017-02-09
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Taxonomy Information

Taxonomy Code 103TC2200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical Child & Adolescent

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

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1942794870 Annie Rabinovitch Psychologist 1132 Annapolis Rd Ste 200, Odenton, MD 21113-1673 2018-06-14
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1477938215 Deborah A Odonnell, Phd, Clinical Psychologist, LLC Psychologist 41660 Courthouse Dr # 201c, Leonardtown, MD 20650-3887 2015-07-22
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1225438344 Marjorie Katherine Mccalla Psychologist 720 Aliceanna St, Baltimore, MD 21202-4387 2014-08-26
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Competitor

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City RANDALLSTOWN
Zip Code 21133

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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