Provider Demographics
NPI:1548858517
Name:MARTIN-COLEMAN, MARIKA L
Entity type:Individual
Prefix:
First Name:MARIKA
Middle Name:L
Last Name:MARTIN-COLEMAN
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 1:16017 PARTELL CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1638
Mailing Address - Country:US
Mailing Address - Phone:202-230-1987
Mailing Address - Fax:
Practice Address - Street 1:6008 BELL STATION RD
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9137
Practice Address - Country:US
Practice Address - Phone:866-588-0477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM593106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist