Provider Demographics
NPI:1023556065
Name:RENDON, MARIA JOSE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:JOSE
Last Name:RENDON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 KING FARM BOULEVARD
Mailing Address - Street 2:SUITE 125, #1102
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2355
Mailing Address - Country:US
Mailing Address - Phone:240-200-0842
Mailing Address - Fax:
Practice Address - Street 1:12712 DEEP SPRING DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2355
Practice Address - Country:US
Practice Address - Phone:786-281-4742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9794103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling