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General NPI Number Information
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NPI Number | 1083896856
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Entity Type | Organization
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Legal Business Name | MARYANN SYERS, PHD, LLC
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 109 NORTH BEACH RD. - 284
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City | EASTSOUND
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State | WA
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Zip | 98245-1935
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Country | US
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Telephone | 360-376-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 109 NORTH BEACH RD. - 284
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City | EASTSOUND
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State | WA
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Zip | 98245-1935
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Country | US
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Telephone | 360-376-6100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARYANN SYERS
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Credential | PH.D.
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Telephone | 612-343-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW60324566
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License Number State | WA
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