Diane Alicia Tennies in Bangor - Addiction (substance Use Disorder)
Diane Alicia Tennies - NPI 1023168531
Diane Alicia Tennies is a Addiction (substance Use Disorder) in Bangor, Maine. Diane Alicia Tennies practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Diane Alicia Tennies is 1023168531. The last update date is 2013-04-16.
Diane Alicia Tennies's current location address is 115 Franklin St, Bangor, Maine. You can contact this provider via phone number 2079423635 and fax number 2079411933. The mailing address for Diane Alicia Tennies is 115 Franklin St, Bangor, Maine. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Diane Alicia Tennies |
|---|---|
| Address | 115 Franklin St, Bangor, Maine |
| Phone Number | 2079423635 |
| Fax Number | 2079411933 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1023168531 |
|---|---|
| Provider Enumeration Date | 2007-01-10 |
| Last Updated Date | 2013-04-16 |
Provider Mailing Address Detail
| Address | 115 Franklin St |
|---|---|
| City | Bangor |
| State | Maine (ME) |
| Post Code | 44014936 |
| Phone Number | 2079423635 |
| Fax Number | 2079411933 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 103Ta0400X |
| Licence No | LC 1572 |
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Definition: A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., ga |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 43983 | ME | BLUE CROSS BLUE SHIELD | |
| 231220000 | ME | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Diane Alicia Tennies?
The Diane Alicia Tennies has been issued the NPI (National Provider Identifier) 1023168531 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Diane Alicia Tennies?
The Diane Alicia Tennies is situated at 115 Franklin St, in the city of Bangor, state of ME, with the zip code 44014936.
What is Diane Alicia Tennies's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Diane Alicia Tennies's specialized field of practice is Addiction (substance Use Disorder), and the corresponding taxonomy code that categorizes this area of specialization is 103Ta0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1023168531 to Diane Alicia Tennies?
The Centers for Medicare & Medicaid Services assigned the 1023168531 to Diane Alicia Tennies on 2007-01-10.
As of what date was the information pertaining to Diane Alicia Tennies, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Diane Alicia Tennies, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2013-04-16.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY