Provider Demographics
NPI:1306686134
Name:CARPENTER, MARI CHENEY (MPH, NBC-HWC, CHES)
Entity type:Individual
Prefix:
First Name:MARI
Middle Name:CHENEY
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MPH, NBC-HWC, CHES
Other - Prefix:
Other - First Name:MARI
Other - Middle Name:CHENEY
Other - Last Name:NOVOSAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, NBC-HWC, CHES
Mailing Address - Street 1:800 ROCKWELL AVE APT 391
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4784
Mailing Address - Country:US
Mailing Address - Phone:240-535-1552
Mailing Address - Fax:
Practice Address - Street 1:800 ROCKWELL AVE APT 391
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-4784
Practice Address - Country:US
Practice Address - Phone:240-535-1552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17430174H00000X
MDA-3939149171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No174H00000XOther Service ProvidersHealth Educator