Marta G Chaney Llc | |
3691 Park Ave Ellicott City MD 21043-4783 | |
(410) 707-5893 | |
Not Available |
Full Name | Marta G Chaney Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 3691 Park Ave, Ellicott City, Maryland |
Authorized Official Name and Position | Marta Gay Chaney (OWNER) |
Authorized Official Contact | 4107075893 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Marta G Chaney Llc 5501 Suffield Ct Columbia MD 21044-2772 Ph: () - | Marta G Chaney Llc 3691 Park Ave Ellicott City MD 21043-4783 Ph: (410) 707-5893 |
NPI Number | 1588900427 |
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Provider Enumeration Date | 12/21/2012 |
Last Update Date | 12/21/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588900427 | NPI | - | NPPES |
K452 | Other | BSDC | |
PVPB117117 | Other | APS | |
150N | Other | MBMD | |
150N119G | Other | MEDICARE UNSPECIFIED | |
0003 | Other | BSDC | |
150N119G | Other | MBMD | |
253537 | Other | COMP | |
226574 | Other | KAIS | |
331942 | Other | MHN | |
360218 | Other | MHN | |
54264604 | Other | BSMD | |
252450 | Other | COMP | |
705BPS | Other | BSMD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 05213 (Maryland) | Primary |
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