Healthcare Provider Details

I. General information

NPI: 1841999075
Provider Name (Legal Business Name): MARY BATTLE-WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 PENNSYLVANIA AVE SE
WASHINGTON DC
20020-3718
US

IV. Provider business mailing address

1016 ANDEAN GOOSE WAY UPPR MARLBORO
UPPER MARLBORO MD
20774-7128
US

V. Phone/Fax

Practice location:
  • Phone: 202-581-0490
  • Fax:
Mailing address:
  • Phone: 301-332-7805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: