Healthcare Provider Details

I. General information

NPI: 1245334366
Provider Name (Legal Business Name): MS. MARY MARGARET DUMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY MARGARET DUMAS LMHC

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 ROUTE 6A SUITE 9
YARMOUTH PORT MA
02675-1900
US

IV. Provider business mailing address

79 WASHINGTON AVENUE
WEST YARMOUTH MA
02673
US

V. Phone/Fax

Practice location:
  • Phone: 508-280-2421
  • Fax:
Mailing address:
  • Phone: 508-790-8250
  • Fax: 508-790-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number108
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: