Provider Demographics
NPI:1629208947
Name:HORTON, MARIAN W (LGSW)
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:W
Last Name:HORTON
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1682 E GUDE DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5303
Mailing Address - Country:US
Mailing Address - Phone:301-610-7690
Mailing Address - Fax:301-610-7691
Practice Address - Street 1:1682 E GUDE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5303
Practice Address - Country:US
Practice Address - Phone:301-610-7690
Practice Address - Fax:301-610-7691
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD151351041C0700X
DCLG500787841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical