1780737635 NPI number — MS. MELISSA ANN MAURER MSW

Table of content: MS. MELISSA ANN MAURER MSW (NPI 1780737635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780737635 NPI number — MS. MELISSA ANN MAURER MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAURER
Provider First Name:
MELISSA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRATCHER
Provider Other First Name:
MELISSA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780737635
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 93RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEENE
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03431-3748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-357-5275
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 VOSE FARM RD
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
PETERBOROUGH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03458-2154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-924-7236
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  6801058817 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)