Provider Demographics
NPI:1619678653
Name:WOODLAND, MARSHA ANNETTE
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:ANNETTE
Last Name:WOODLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5945 HIL MAR DR
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2984
Mailing Address - Country:US
Mailing Address - Phone:240-601-7568
Mailing Address - Fax:202-290-1501
Practice Address - Street 1:5949 HIL MAR DR
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-2984
Practice Address - Country:US
Practice Address - Phone:240-601-7568
Practice Address - Fax:202-290-1501
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health