Provider Demographics
NPI:1124149265
Name:COURNOYER, MARIE E (MS RN CS-P)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:E
Last Name:COURNOYER
Suffix:
Gender:F
Credentials:MS RN CS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 DUCKETTS LN
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6126
Mailing Address - Country:US
Mailing Address - Phone:410-796-8140
Mailing Address - Fax:
Practice Address - Street 1:10630 LITTLE PATUXENT PKWY STE 212
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-6226
Practice Address - Country:US
Practice Address - Phone:410-740-0333
Practice Address - Fax:410-740-0332
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR072594101YM0800X, 106H00000X, 163WP0808X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR072594OtherRN LICENSE NUMBER