Provider Demographics
NPI:1811360472
Name:KAPLAN, MARISSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:
Last Name:KAPLAN
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 1:3505 ORCHARD SHADE RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2457
Mailing Address - Country:US
Mailing Address - Phone:732-925-2230
Mailing Address - Fax:
Practice Address - Street 1:611 PARK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4572
Practice Address - Country:US
Practice Address - Phone:410-777-8130
Practice Address - Fax:410-777-8134
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05519103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical