=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336768548
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY E MARCH LGMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2020
-----------------------------------------------------
Last Update Date | 04/09/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3425 EMORY CHURCH RD
-----------------------------------------------------
City | OLNEY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20832-2613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-801-5671
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7702 EAGLES HEAD CT
-----------------------------------------------------
City | DERWOOD
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20855-2235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-710-8937
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | LGM759
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------