Provider Demographics
NPI:1861706798
Name:ROFFMAN, NANCY (PSYD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ROFFMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10400 STEVENSON RD STE 201-5
Mailing Address - Street 2:P.O. BOX 228
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-0600
Mailing Address - Country:US
Mailing Address - Phone:410-561-3651
Mailing Address - Fax:
Practice Address - Street 1:10400 STEVENSON RD STE 201-5
Practice Address - Street 2:BOX 228
Practice Address - City:STEVENSON
Practice Address - State:MD
Practice Address - Zip Code:21153-0600
Practice Address - Country:US
Practice Address - Phone:410-561-3651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist