Mary Knorring Pantuhova in Waban - Clinical
Mary Knorring Pantuhova - NPI 1497701197
Mary Knorring Pantuhova is a Clinical in Waban, Massachusetts. Mary Knorring Pantuhova practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Knorring Pantuhova is 1497701197. The last update date is 2009-12-08.
Mary Knorring Pantuhova's current location address is 91 Wyman St, Waban, Massachusetts. You can contact this provider via phone number 6173327596 and fax number 6176636135. The mailing address for Mary Knorring Pantuhova is 91 Wyman St, Waban, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Knorring Pantuhova |
|---|---|
| Address | 91 Wyman St, Waban, Massachusetts |
| Phone Number | 6173327596 |
| Fax Number | 6176636135 |
| Sole Proprietor | N |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1497701197 |
|---|---|
| Provider Enumeration Date | 2006-05-25 |
| Last Updated Date | 2009-12-08 |
Provider Mailing Address Detail
| Address | 91 Wyman St |
|---|---|
| City | Waban |
| State | Massachusetts (MA) |
| Post Code | 24681529 |
| Phone Number | 6173327596 |
| Fax Number | 6176636135 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 6733 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| W40013 | MA | MEDICARE | |
| 1497701197 | MA | NPI |
Post Comment/ Review Below
What is the Mary Knorring Pantuhova's unique identification number?
The Mary Knorring Pantuhova has been assigned the NPI (National Provider Identifier) Number 1497701197 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Mary Knorring Pantuhova is physically located?
The Mary Knorring Pantuhova is situated at the following address: 91 Wyman St, Waban, MA 24681529.
What is the Mary Knorring Pantuhova's specialty and taxonomy code?
The Mary Knorring Pantuhova's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did the Mary Knorring Pantuhova receive the assignment of its 1497701197 from the Centers for Medicare & Medicaid Services?
The Mary Knorring Pantuhova was issued its 1497701197 by the Centers for Medicare & Medicaid Services on 2006-05-25.
As of what date were the Mary Knorring Pantuhova's details last updated?
The information pertaining to the Mary Knorring Pantuhova, including its address, specialty, and other details, was most recently updated on 2009-12-08.