Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 1-07-3578 | |
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 04764 | MD |
NPI | 1013245901 |
---|---|
Provider Name | Dr. Mary Joy Kolb |
First Address | Gaithersburg, MD 20878-5471 |
Second Address | Gaithersburg, MD 20878-5471 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2009 |
Last Update Date | 12/07/2011 |