Provider Demographics
NPI:1225438344
Name:MCCALLA, MARJORIE KATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:KATHERINE
Last Name:MCCALLA
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 1:720 ALICEANNA ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4387
Mailing Address - Country:US
Mailing Address - Phone:443-923-7481
Mailing Address - Fax:
Practice Address - Street 1:720 ALICEANNA ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4387
Practice Address - Country:US
Practice Address - Phone:443-923-7481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent