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Individual

MARY NEAL VIETEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
20797 RED ROSE CT, LEXINGTON PARK, MD 20653-2447
(301) 769-8081
Mailing address
PO BOX 222, PATUXENT RIVER, MD 20670-0222
(301) 769-8081

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
04514
MD
103TC0700X
Clinical Psychologist
20041604A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
415557800
MD
Enumeration date
01/09/2006
Last updated
11/29/2021
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