Provider Demographics
NPI:1518198159
Name:MARINELLI, STEPHANIE BABB (PHD, JD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BABB
Last Name:MARINELLI
Suffix:
Gender:F
Credentials:PHD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 EXCELSIOR SPRINGS CT.
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-262-9662
Mailing Address - Fax:
Practice Address - Street 1:2904 EXCELSIOR SPRINGS CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7614
Practice Address - Country:US
Practice Address - Phone:410-262-9662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3183101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral