Provider Demographics
NPI:1871922096
Name:NESTOR, MARIE (SOCIAL WORKER)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:
Last Name:NESTOR
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 CLAIRTON DR
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2120
Mailing Address - Country:US
Mailing Address - Phone:301-805-7211
Mailing Address - Fax:202-727-7802
Practice Address - Street 1:4001 CLAIRTON DR
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-2120
Practice Address - Country:US
Practice Address - Phone:301-805-7211
Practice Address - Fax:202-727-7802
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1041000000X104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker