Provider Demographics
NPI:1861983710
Name:VIEYRA, MARIE ANNE B (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIE ANNE
Middle Name:B
Last Name:VIEYRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RUE BOSIO
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:ILE DE FRANCE
Mailing Address - Zip Code:75016
Mailing Address - Country:FR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 RUE BOSIO
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:ILE DE FRANCE
Practice Address - Zip Code:75016
Practice Address - Country:FR
Practice Address - Phone:014-050-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-27
Last Update Date:2018-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6240-PY-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical