Provider Demographics
NPI:1952511768
Name:DUBNER, MARYANN POLLACK (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARYANN
Middle Name:POLLACK
Last Name:DUBNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 MONTGOMERY LN
Mailing Address - Street 2:#206
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3471
Mailing Address - Country:US
Mailing Address - Phone:202-365-0609
Mailing Address - Fax:
Practice Address - Street 1:4501 CONNECTICUT AVE NW
Practice Address - Street 2:#109
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3710
Practice Address - Country:US
Practice Address - Phone:202-365-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC586103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist