Provider Demographics
NPI:1336932854
Name:VASSEUR, ANTOINETTE ELIZABETH (CNIP, THP)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:ELIZABETH
Last Name:VASSEUR
Suffix:
Gender:F
Credentials:CNIP, THP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:MD
Mailing Address - Zip Code:21716-1414
Mailing Address - Country:US
Mailing Address - Phone:301-693-6765
Mailing Address - Fax:
Practice Address - Street 1:611 W PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4027
Practice Address - Country:US
Practice Address - Phone:240-439-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health