| Doctor Name: | MISS MAUDE V FASSETT |
| NPI Number: | 1316152556 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW ACSW MSW |
| License Number: | PR0084731 |
| Business Practice Address: | 70-14 Lakewood Ct Apt 14 Moriches, NY - 11955 |
| Business Phone Number: | 6318743877 |
| Business Fax Number: | |
| Mailing Address: | 70-14 Lakewood Ct, Apt 14 MORICHES |
| State: | NY |
| Postal Code: | 11955 |
| Phone Number: | 6318743877 |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | PR0084731 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |