Provider Demographics
NPI:1366961401
Name:DRUCKENMILLER, MARIE E (RBT)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:E
Last Name:DRUCKENMILLER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PLATEAU PL UNIT F
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3706
Mailing Address - Country:US
Mailing Address - Phone:571-201-3832
Mailing Address - Fax:
Practice Address - Street 1:5416 16TH AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3444
Practice Address - Country:US
Practice Address - Phone:855-255-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-10
Last Update Date:2017-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-17-35550106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician