Symone Colquitt

Individual provider Active NPI Marriage & Family Therapist · College Park, MD

NPI 1578083630 · NPPES record last updated Jun 20, 2017

Key facts

NPI
1578083630
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LMC402 (MD)
Practice address
7309 Baltimore Ave Ste 117
College Park, MD 20740-3200
Phone
(301) 213-1755
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LMC402MDMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMC402 MD Yes

Addresses

Primary practice location

7309 Baltimore Ave Ste 117
College Park, MD 20740-3200

Mailing address

1805 Crosby Rd
Hyattsville, MD 20783-2918
Phone (301) 422-6779

Other providers in College Park, MD

All providers in College Park, MD · Marriage & Family Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.