Provider Demographics
NPI:1922078021
Name:MOURATIDIS, MARIA NMI (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:NMI
Last Name:MOURATIDIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 SAINT JOHNS LN STE F
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2600
Mailing Address - Country:US
Mailing Address - Phone:443-545-6530
Mailing Address - Fax:
Practice Address - Street 1:3355 SAINT JOHNS LN STE F
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2600
Practice Address - Country:US
Practice Address - Phone:443-545-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04187103TC0700X
CT002553103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist