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General NPI Number Information
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NPI Number | 1548318611
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Entity Type | Organization
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Legal Business Name | MRB COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 315 E DIAMOND AVE SUITE A
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City | GAITHERSBURG
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State | MD
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Zip | 20877-3071
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Country | US
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Telephone | 301-527-0854
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Fax | 240-243-1061
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Provider Business Mailing Address
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Address Line | 1029 BEXHILL DRIVE
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City | FREDERICK
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State | MD
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Zip | 21702
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Country | US
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Telephone | 301-512-0663
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MARIA ROSA BUSTOS
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Credential | PHD
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Telephone | 301-527-0854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCA372
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License Number State | MD
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