Provider Demographics
NPI:1679770796
Name:VERRIER, MARYDANIELLE ANN (LDCP1)
Entity type:Individual
Prefix:
First Name:MARYDANIELLE
Middle Name:ANN
Last Name:VERRIER
Suffix:
Gender:F
Credentials:LDCP1
Other - Prefix:MRS
Other - First Name:MARYDANIELLE
Other - Middle Name:ANN
Other - Last Name:VERRIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LDCP1
Mailing Address - Street 1:148 VINNICUM RD
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3430
Mailing Address - Country:US
Mailing Address - Phone:508-567-2828
Mailing Address - Fax:
Practice Address - Street 1:1563 N MAIN ST
Practice Address - Street 2:SUITE208
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2917
Practice Address - Country:US
Practice Address - Phone:508-324-1060
Practice Address - Fax:508-672-3619
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health