Provider Demographics
NPI:1710346721
Name:MCNERNEY, THERESE (DPT)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:MCNERNEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 ROCK SPRING DR
Mailing Address - Street 2:155
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1132
Mailing Address - Country:US
Mailing Address - Phone:301-564-6022
Mailing Address - Fax:301-564-3737
Practice Address - Street 1:6550 ROCK SPRING DR
Practice Address - Street 2:155
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1132
Practice Address - Country:US
Practice Address - Phone:301-564-6022
Practice Address - Fax:301-564-3737
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19022174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist