Doctor Name: | MS. SUSAN A ANZIVINO |
NPI Number: | 1790774479 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | CC433 |
Business Practice Address: | 131 Franklin Health Cmns Ste A Farmington, ME - 049386142 |
Business Phone Number: | 2077780035 |
Business Fax Number: | 2077786879 |
Mailing Address: | 131 Franklin Health Cmns, Ste A FARMINGTON |
State: | ME |
Postal Code: | 049386142 |
Phone Number: | 2077780035 |
Fax Number: | 2077786879 |
NPI Enumeration Date: | 10/17/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | CC433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |