Doctor Name: | PETER MICHAEL MAHAR |
NPI Number: | 1063592517 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LCMHC |
License Number: | 068-0000394 |
Business Practice Address: | 128 Merchants Row Office 602 Rutland, VT - 057015909 |
Business Phone Number: | 8027731411 |
Business Fax Number: | 8027739811 |
Mailing Address: | Po Box 422, CASTLETON |
State: | VT |
Postal Code: | 057350422 |
Phone Number: | 8027731411 |
Fax Number: | 8027739811 |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 068-0000394 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |