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NPI Code Detail

MEDICARE: DR. MAURA MULLOY PHD

MEDICARE:  DR. MAURA  MULLOY  PHD
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
1103T00000XPsychologist05975MD

General Provider Information

NPI Number : 1366957979
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAURA MULLOY PHD
Provider Business Mailing Address
First Line : 1111 NOTLEY RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-6243
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1111 NOTLEY RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-6243
Country : US
Telephone Number : 703-408-2867
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2017
Last Update Date : 12/05/2017

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Directions to “ DR. MAURA MULLOY PHD” Practice Location

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