Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY1612 | DC |
N | 103T00000X | Psychologist | PSY1612 | DC |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY1612 | DC |
Y | 103G00000X | Clinical Psychologist | PSY1612 | DC |
Y | 103TC0700X | Clinical Psychologist | PSY1612 | DC |
NPI | 1013431964 |
---|---|
Provider Name | Sheilah S. Maramark Thomas |
First Address | Clinton, MD 20735-2630 |
Second Address | Washington, DC 20032-4301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2017 |
Last Update Date | 02/08/2017 |