Healthcare Provider Details

I. General information

NPI: 1831065424
Provider Name (Legal Business Name): NINA MARIE BURLEIGH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8909 RIGGS RD
ADELPHI MD
20783-1633
US

IV. Provider business mailing address

8909 RIGGS RD
ADELPHI MD
20783-1633
US

V. Phone/Fax

Practice location:
  • Phone: 301-431-5650
  • Fax: 301-431-5606
Mailing address:
  • Phone: 301-431-5650
  • Fax: 301-431-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1001513320
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: