Individual
MISS MARJORIE CELESTE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADT
Contact information
Practice address
2825 MOUNTAIN ROAD, SUITE 204, PASADENA, MD 21122-0427
(443) 548-3733
(410) 360-1675
Mailing address
2825 MOUNTAIN ROAD, SUITE 204, PASADENA, MD 21122-0427
(443) 548-3733
(410) 360-1675
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT1907
MD
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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