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General NPI Number Information
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NPI Number | 1548032550
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Entity Type | Individual
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Provider Name | MARINA KERLOW LGMFT
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 7000 CARROLL AVE
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City | TAKOMA PARK
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State | MD
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Zip | 20912-4437
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Country | US
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Telephone | 301-919-2356
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Fax |
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Provider Business Mailing Address
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Address Line | 11865 FEDERAL SQ STE 106
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City | WALDORF
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State | MD
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Zip | 20602-3226
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Country | US
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Telephone | 301-892-6811
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LGM981
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License Number State | MD
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