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Individual

MARY EVELYN ROUSE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
APRN, PMH

Contact information

Practice address
9055 SHADY GROVE CT, GAITHERSBURG, MD 20877-1301
(301) 330-0400
(301) 948-4333
Mailing address
9055 SHADY GROVE CT, GAITHERSBURG, MD 20877-1301
(301) 330-0400
(301) 948-4333

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R043705
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
311421
UNITED HEALTHCARE-MAMSI
MD
Enumeration date
05/27/2006
Last updated
07/08/2007
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