Provider Demographics
NPI:1497886626
Name:DOUGLAS, MARCIA ANNETTE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ANNETTE
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:MARCIA
Other - Middle Name:ANNETTE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:8448 BEAUTIFUL VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-6562
Mailing Address - Country:US
Mailing Address - Phone:615-646-9585
Mailing Address - Fax:
Practice Address - Street 1:915 8TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2621
Practice Address - Country:US
Practice Address - Phone:615-460-4112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool