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Contact Information

ETHAN BLISS, PHD
340 PARK AVE
FREDERICK, MD21701-4931
 Phone: 301-663-1683
 Fax: 301-663-3792
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Mental Health

101YM0800X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ETHAN BLISS · (Male)

NPI Number 1851428460
Status Active
Credentials PHD
Entity Individual
Enumeration date 02/28/2007
Last updated 11/22/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • FL License # MH 7447
  • IN License # 20042437A
  • IN License # 39001937A
  • MD License # 04888
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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