Healthcare Provider Details

I. General information

NPI: 1023921103
Provider Name (Legal Business Name): EMALEA MARKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 JONATHAN ST
HAGERSTOWN MD
21740-4801
US

IV. Provider business mailing address

53 EASTERN AVE APT D
GREENCASTLE PA
17225-1168
US

V. Phone/Fax

Practice location:
  • Phone: 443-708-3887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: