Doctor Name: | MARYANNE SEREDYNSKI |
NPI Number: | 1053781690 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC-C |
License Number: | XL44204 |
Business Practice Address: | 54 Water St Wiscasset, ME - 04578 |
Business Phone Number: | 2076071312 |
Business Fax Number: | |
Mailing Address: | 19 Murray Rd, WESTPORT ISLAND |
State: | ME |
Postal Code: | 045783124 |
Phone Number: | 2076071312 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2015 |
NPI Last Update Date: | 09/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | XL44204 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |