Provider Demographics
NPI:1619200821
Name:JOBE, CAROLA MERLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROLA
Middle Name:MERLA
Last Name:JOBE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 SUPERIOR LN
Mailing Address - Street 2:STE A5
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1939
Mailing Address - Country:US
Mailing Address - Phone:301-306-4590
Mailing Address - Fax:
Practice Address - Street 1:3231 SUPERIOR LN
Practice Address - Street 2:STE A5
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1939
Practice Address - Country:US
Practice Address - Phone:301-306-4590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04762103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical