Provider Demographics
NPI:1861882839
Name:HLUSKA, MARY ELLEN
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELLEN
Last Name:HLUSKA
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 1:205 ATLANTA CT
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-2013
Mailing Address - Country:US
Mailing Address - Phone:410-599-5028
Mailing Address - Fax:
Practice Address - Street 1:260 GATEWAY DR
Practice Address - Street 2:SUITE 3-4
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4268
Practice Address - Country:US
Practice Address - Phone:410-599-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDATC096101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor