Provider Demographics
NPI:1982127650
Name:KURZ, MARYELIZABETH ANNE
Entity Type:Individual
Prefix:MRS
First Name:MARYELIZABETH
Middle Name:ANNE
Last Name:KURZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 S DEAN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7207 BALTIMORE ANNAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2684
Practice Address - Country:US
Practice Address - Phone:609-351-1557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2020-05-29
Deactivation Date:2020-05-05
Deactivation Code:
Reactivation Date:2020-05-28
Provider Licenses
StateLicense IDTaxonomies
MDLC10445101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional