Provider Demographics
NPI:1871879957
Name:MCMAHON, MAUREEN
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 CYPRESS ST
Mailing Address - Street 2:4F
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3626
Mailing Address - Country:US
Mailing Address - Phone:603-321-5954
Mailing Address - Fax:
Practice Address - Street 1:335 CYPRESS ST
Practice Address - Street 2:4F
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3626
Practice Address - Country:US
Practice Address - Phone:603-321-5954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)