Doctor Name: | MARCELLA GORDON WALDER |
NPI Number: | 1104025428 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | 0251 |
Business Practice Address: | 16 Lakeside Dr Greenbelt, MD - 207701904 |
Business Phone Number: | 3014742146 |
Business Fax Number: | 3014741544 |
Mailing Address: | 16 Lakeside Dr, GREENBELT |
State: | MD |
Postal Code: | 207701904 |
Phone Number: | 3014742146 |
Fax Number: | 3014741544 |
NPI Enumeration Date: | 07/17/2007 |
NPI Last Update Date: | 07/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0251 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |