MEDICARE: MARJANNE CZIFRA MS, LGMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LGM612	MD

General Provider Information

NPI Number	:	1144766395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJANNE CZIFRA MS, LGMFT

Provider Business Mailing Address
First Line	:	24238 KINGS VALLEY RD
Second Line	:	SUITE 1
City	:	DAMASCUS
State	:	MD
Zip	:	20872-2221
Country	:	US
Telephone Number	:	240-406-8918
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 DECATUR AVE
Second Line	:	SUITE 1
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2148
Country	:	US
Telephone Number	:	240-406-8918
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2017
Last Update Date	:	01/29/2019

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