Provider Demographics
NPI:1285773242
Name:ALVORD, MARY K (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:ALVORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 TOWER OAKS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4216
Mailing Address - Country:US
Mailing Address - Phone:301-593-6554
Mailing Address - Fax:301-255-0461
Practice Address - Street 1:3200 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4216
Practice Address - Country:US
Practice Address - Phone:301-593-6554
Practice Address - Fax:301-255-0461
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01269103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD00B146A55Medicare ID - Type Unspecified