Doctor Name: | MRS. MARIA LYNN D'AMICO |
NPI Number: | 1073812319 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.C. |
License Number: | 0602180 |
Business Practice Address: | 857 Eaglewood Dr Willoughby, OH - 440947103 |
Business Phone Number: | 2167023823 |
Business Fax Number: | |
Mailing Address: | 857 Eaglewood Dr, WILLOUGHBY |
State: | OH |
Postal Code: | 440947103 |
Phone Number: | 2167023823 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2011 |
NPI Last Update Date: | 03/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0602180 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |