Doctor Name: | DR. MARY FEGURGUR |
NPI Number: | 1205139714 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D., LCSW |
License Number: | LCS18780 |
Business Practice Address: | 426 Chalan San Antonio Ste 104 Tamuning, GU - 969133631 |
Business Phone Number: | 6716495910 |
Business Fax Number: | |
Mailing Address: | Pob 326598, HAGATNA |
State: | GUAM |
Postal Code: | 96932 |
Phone Number: | 6714834278 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2010 |
NPI Last Update Date: | 12/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS18780 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |