=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871922096
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIE NESTOR SOCIAL WORKER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2013
-----------------------------------------------------
Last Update Date | 11/07/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4001 CLAIRTON DR
-----------------------------------------------------
City | MITCHELLVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20721-2120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-805-7211
-----------------------------------------------------
Fax | 202-727-7802
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4001 CLAIRTON DR
-----------------------------------------------------
City | MITCHELLVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20721-2120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-805-7211
-----------------------------------------------------
Fax | 202-727-7802
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 1041000000X
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------