Provider Demographics
NPI:1134335326
Name:URIE, MARYLYNNE M (MS, LMFT)
Entity type:Individual
Prefix:
First Name:MARYLYNNE
Middle Name:M
Last Name:URIE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36637 WOODMAR FARM DR
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3975
Mailing Address - Country:US
Mailing Address - Phone:571-271-3119
Mailing Address - Fax:
Practice Address - Street 1:36637 WOODMAR FARM DR
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3975
Practice Address - Country:US
Practice Address - Phone:571-271-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01018106H00000X
VA0717001188106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist