Provider Demographics
NPI:1235697442
Name:NIGHTINGALE, MARJORIE ANN (MA)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:ANN
Last Name:NIGHTINGALE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13525 BENTLEY CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4330
Mailing Address - Country:US
Mailing Address - Phone:267-994-9016
Mailing Address - Fax:
Practice Address - Street 1:1320 19TH ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1637
Practice Address - Country:US
Practice Address - Phone:202-629-1949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health