| Doctor Name: | MS. MARY ELLEN MAENNER |
| NPI Number: | 1053564062 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.P.C. |
| License Number: | LC2866 |
| Business Practice Address: | 10 Gerard Ave Suite 210 Timonium, MD - 210933235 |
| Business Phone Number: | 4102521030 |
| Business Fax Number: | |
| Mailing Address: | 8359 Hillendale Rd, BALTIMORE |
| State: | MD |
| Postal Code: | 212345003 |
| Phone Number: | 4437940000 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2008 |
| NPI Last Update Date: | 11/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC2866 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |