Healthcare Provider Details

I. General information

NPI: 1417385600
Provider Name (Legal Business Name): MARCIA STUART PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2013
Last Update Date: 10/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 1ST ST NE
WASHINGTON DC
20002-3361
US

IV. Provider business mailing address

12408 MARLEIGH DR
BOWIE MD
20720-3732
US

V. Phone/Fax

Practice location:
  • Phone: 202-442-4800
  • Fax: 202-442-5518
Mailing address:
  • Phone: 202-579-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: