Provider Demographics
NPI:1487315248
Name:LEITH, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LEITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6719 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4809
Mailing Address - Country:US
Mailing Address - Phone:703-851-5116
Mailing Address - Fax:
Practice Address - Street 1:6719 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-4809
Practice Address - Country:US
Practice Address - Phone:703-851-5116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program