Provider Demographics
NPI:1417391061
Name:BRICKLEY, MARIA VITTORIA (MA, NCSP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:VITTORIA
Last Name:BRICKLEY
Suffix:
Gender:F
Credentials:MA, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8227 CLOVERLEAF DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1565
Mailing Address - Country:US
Mailing Address - Phone:410-292-0016
Mailing Address - Fax:888-224-0984
Practice Address - Street 1:8227 CLOVERLEAF DR
Practice Address - Street 2:SUITE 303
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1565
Practice Address - Country:US
Practice Address - Phone:410-292-0016
Practice Address - Fax:888-224-0984
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist