Provider Demographics
NPI:1215710041
Name:BLAND, MARY-ANN MAAMA (LCSW)
Entity type:Individual
Prefix:
First Name:MARY-ANN
Middle Name:MAAMA
Last Name:BLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4823 DAPPLED GROVE TRL
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3596
Mailing Address - Country:US
Mailing Address - Phone:412-728-3123
Mailing Address - Fax:
Practice Address - Street 1:1182 ELLINGTON FLD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5607
Practice Address - Country:US
Practice Address - Phone:512-782-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX655351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical