Provider Demographics
NPI:1538178975
Name:IGNELZI-FERRARO, DONNA MARIE (PHD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:IGNELZI-FERRARO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11042 NICHOLAS LN
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:OCEAN PINES
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3299
Mailing Address - Country:US
Mailing Address - Phone:410-208-4784
Mailing Address - Fax:410-208-4786
Practice Address - Street 1:11042 NICHOLAS LN
Practice Address - Street 2:SUITE 103B
Practice Address - City:OCEAN PINES
Practice Address - State:MD
Practice Address - Zip Code:21811-3299
Practice Address - Country:US
Practice Address - Phone:410-208-4784
Practice Address - Fax:410-208-4786
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04036103T00000X
DEB10000425103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD54867704OtherBCBS OF MD
MDG8000002OtherBCBS NATIONAL
MDPVPB179236OtherAPS
MD322005OtherTRICARE
MD359615OtherMAMSI
MD6172984OtherUNITED BEHAVIORAL HEALTH
MD7332418OtherAETNA
MD7332418OtherAETNA