Healthcare Provider Details

I. General information

NPI: 1730993973
Provider Name (Legal Business Name): EMMA PERSICO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 WOODMONT AVE STE 840
BETHESDA MD
20814-2789
US

IV. Provider business mailing address

8621 GEORGIA AVE APT 808
SILVER SPRING MD
20910-3869
US

V. Phone/Fax

Practice location:
  • Phone: 240-618-2889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLGM1205
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: