| Doctor Name: | MARY C. FENIMORE |
| NPI Number: | 1003105339 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 429 |
| Business Practice Address: | 1151 Walker Rd Dover, DE - 199046600 |
| Business Phone Number: | 3026742380 |
| Business Fax Number: | |
| Mailing Address: | 1151 Walker Rd, DOVER |
| State: | DE |
| Postal Code: | 199046600 |
| Phone Number: | 3026742380 |
| Fax Number: | |
| NPI Enumeration Date: | 04/07/2011 |
| NPI Last Update Date: | 07/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 429 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |