Provider Demographics
NPI:1427880178
Name:DEVOSE, MAKIESE N (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:MAKIESE
Middle Name:N
Last Name:DEVOSE
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 SAINT JOSEPHS DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3780
Mailing Address - Country:US
Mailing Address - Phone:610-476-0803
Mailing Address - Fax:
Practice Address - Street 1:12 S SUMMIT AVE STE 100-A06
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2089
Practice Address - Country:US
Practice Address - Phone:610-476-0803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27054104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker