Provider Demographics
NPI:1871784538
Name:MUNFORD, MARIA BERNADETTE (MA)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:BERNADETTE
Last Name:MUNFORD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 COLONY DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-4156
Mailing Address - Country:US
Mailing Address - Phone:252-633-4322
Mailing Address - Fax:252-633-2951
Practice Address - Street 1:1235 COLONY DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-4156
Practice Address - Country:US
Practice Address - Phone:252-633-4322
Practice Address - Fax:252-633-2951
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1877103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical