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Individual
DR. MARY ELLEN AGOLIA
Active
Individual
DR. MARY ELLEN AGOLIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1188
NM
104100000X
Social Worker
M0432
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N3745
—
NM
Enumeration date
11/14/2006
Last updated
03/21/2021
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