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Organization

MARY E. ROUSE MS, APRN, BC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARY E. ROUSE APRN/PMH, BC (CLINICAL NURSE SPECIALIST)
(301) 938-1634
Entity
Organization

Contact information

Practice address
7625 MAPLE LAWN BLVD, SUITE 145, FULTON, MD 20759-2565
(301) 938-1634
Mailing address
7625 MAPLE LAWN BLVD, FULTON, MD 20759-2565
(301) 938-1634

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
R043705
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1831146935
INDIVIDUAL NPI
MD
Enumeration date
05/03/2010
Last updated
02/09/2016
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