Provider Demographics
NPI:1295160299
Name:MAURO, MARIE (ATR-BC, LPC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:MAURO
Suffix:
Gender:F
Credentials:ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4353 LOWER SAUCON RD
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-3328
Mailing Address - Country:US
Mailing Address - Phone:484-456-8837
Mailing Address - Fax:
Practice Address - Street 1:4353 LOWER SAUCON RD
Practice Address - Street 2:
Practice Address - City:HELLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18055-3328
Practice Address - Country:US
Practice Address - Phone:484-456-8837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional