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Individual

MARYJANE BAHIYYIH CORGNATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
170 MIDDLE ST, LANCASTER, NH 03584-3556
(603) 788-2521
(603) 788-5092
Mailing address
173 MIDDLE ST, LANCASTER, NH 03584-3508
(603) 788-5029
(603) 788-5607

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
064044-23
NH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
064044-23
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1031732
VT
05
3110854
NH
Enumeration date
08/12/2017
Last updated
02/18/2019
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