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General NPI Number Information
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NPI Number | 1972161560
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Entity Type | Organization
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Legal Business Name | MARRIAGE HEALTH COACHING, LLC
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 05/30/2019
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Provider Practice Location Address
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Address Line | 3510 WORTHINGTON BLVD STE 101
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City | URBANA
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State | MD
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Zip | 21704-7033
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Country | US
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Telephone | 240-206-1509
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Fax |
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Provider Business Mailing Address
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Address Line | 3510 WORTHINGTON BLVD STE 101
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City | URBANA
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State | MD
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Zip | 21704-7033
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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 | OWNER
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Name | KARA JOHNSON-SMITH
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Credential | LCMFT
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Telephone | 240-423-2009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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