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General NPI Number Information
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NPI Number | 1871719195
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Entity Type | Individual
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Provider Name | JACQUELINE IRENE MARLETTE-BORAS R.D., LDN
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8920 STEPHENS RD SUITE 200
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City | LAUREL
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State | MD
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Zip | 20723
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Country | US
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Telephone | 410-997-7778
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Fax | 410-997-7669
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Provider Business Mailing Address
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Address Line | 8920 STEPHENS RD SUITE 200
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City | LAUREL
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State | MD
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Zip | 20723
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Country | US
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Telephone | 410-997-7778
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Fax | 410-997-7669
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | D00521
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | D00531
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License Number State | MD
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