Provider Demographics
NPI:1871618181
Name:MAFFUID, ANN MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:MAFFUID
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1808
Mailing Address - Country:US
Mailing Address - Phone:860-537-5280
Mailing Address - Fax:560-537-8389
Practice Address - Street 1:87 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1022
Practice Address - Country:US
Practice Address - Phone:860-537-5280
Practice Address - Fax:860-537-8389
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000527106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist