Provider Demographics
NPI:1487412680
Name:MARINER, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MARINER
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 1:199 WALDO RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-5230
Mailing Address - Country:US
Mailing Address - Phone:443-844-5779
Mailing Address - Fax:
Practice Address - Street 1:199 WALDO RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-5230
Practice Address - Country:US
Practice Address - Phone:443-844-5779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula