Provider Demographics
NPI:1700958683
Name:KNARR, STEPHANIE WEILAND (PHD, LCMFT)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:WEILAND
Last Name:KNARR
Suffix:
Gender:F
Credentials:PHD, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 473
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-0473
Mailing Address - Country:US
Mailing Address - Phone:301-490-1011
Mailing Address - Fax:301-490-1484
Practice Address - Street 1:9660 IRON LEAF TRAIL
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723
Practice Address - Country:US
Practice Address - Phone:301-490-1011
Practice Address - Fax:301-490-1484
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDICM174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist