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General NPI Number Information
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NPI Number | 1528128212
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Entity Type | Individual
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Provider Name | MARY B QUARLES LCPC
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2670 CRAIN HIGHWAY SUITE 406
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City | WALDORF
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State | MD
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Zip | 20601
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Country | US
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Telephone | 301-885-0992
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Fax | 301-885-0992
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Provider Business Mailing Address
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Address Line | 12811 ASBURY DRIVE
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City | FORT WASHINGTON
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State | MD
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Zip | 20744
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC2093
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License Number State | MD
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