Pantuhova, Mary Knorring

Pantuhova, Mary Knorring is an individual health care provider with primary practice located at 91 Wyman St , Waban MA 02468-1529. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Pantuhova, Mary Knorring can be contacted via phone (617) 332-7596.

Contact Information

Primary practice address
91 Wyman St Waban MA 02468-1529
Phone: (617) 332-7596
Fax: (617) 663-6135
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6733 Massachusetts
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 6733 Massachusetts

Profile Details

NPI number 1497701197
LBN Legal business name Pantuhova, Mary Knorring
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Dec 8th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497701197 NPPES
Massachusetts Other W40013 MEDICARE
Massachusetts Other 1497701197 MEDICARE

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