Provider Demographics
NPI:1750144036
Name:CARMODY, MARY CHRISTINE (NBH-WC, MPH)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINE
Last Name:CARMODY
Suffix:
Gender:F
Credentials:NBH-WC, MPH
Other - Prefix:
Other - First Name:CHRISSY
Other - Middle Name:
Other - Last Name:CARMODY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:31 S ELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2242
Mailing Address - Country:US
Mailing Address - Phone:202-821-6205
Mailing Address - Fax:
Practice Address - Street 1:31 S ELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2242
Practice Address - Country:US
Practice Address - Phone:202-821-6205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty