Provider Demographics
NPI:1437462645
Name:KAHN, MARISSA BETH (DSW)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:BETH
Last Name:KAHN
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 S BOND ST APT A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3699
Mailing Address - Country:US
Mailing Address - Phone:443-687-8873
Mailing Address - Fax:
Practice Address - Street 1:825 S BOND ST APT A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3699
Practice Address - Country:US
Practice Address - Phone:443-687-8873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
264831041C0700X
MD264831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical