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General NPI Number Information
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NPI Number | 1255757449
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Entity Type | Individual
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Provider Name | ALEXANDREA NICOLE RICH MARS, MSW, LGSW
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Gender | Female
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 3450 LAUREL FORT MEADE RD SUITE 105
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City | LAUREL
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State | MD
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Zip | 20724-2040
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Country | US
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Telephone | 301-490-3825
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 LAUREL FORT MEADE RD SUITE 105
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City | LAUREL
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State | MD
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Zip | 20724-2040
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Country | US
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Telephone | 301-490-3825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LG50080510
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 19406
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License Number State | DC
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