| |
3615 Briarfield Blvd Maumee OH 43537-9381 | |
(419) 378-4072 | |
(419) 406-4044 |
Full Name | |
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Speciality | Counselor |
Location | 3615 Briarfield Blvd, Maumee, Ohio |
Authorized Official Name and Position | Marie Zanfardino (OWNER) |
Authorized Official Contact | 4193784072 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1259 Cambridge Blvd Bowling Green OH 43402-2669 Ph: (419) 236-8071 | 3615 Briarfield Blvd Maumee OH 43537-9381 Ph: (419) 378-4072 |
NPI Number | 1982294054 |
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Provider Enumeration Date | 01/22/2021 |
Last Update Date | 07/29/2024 |
Certification Date | 07/29/2024 |
Medicare PECOS PAC ID | 2163956079 |
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Medicare Enrollment ID | O20241114003822 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982294054 | NPI | - | NPPES |
Provider Name | Marie Zanfardino |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1104050459 PECOS PAC ID: 4981138898 Enrollment ID: I20241114003992 |
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