Provider Demographics
NPI:1437276755
Name:MIGLIORE, MAUREEN GURNEY (MS, LPA)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:GURNEY
Last Name:MIGLIORE
Suffix:
Gender:F
Credentials:MS, LPA
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:GURNEY
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPA
Mailing Address - Street 1:601 CEDAR ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-1999
Mailing Address - Country:US
Mailing Address - Phone:252-838-1605
Mailing Address - Fax:252-838-1304
Practice Address - Street 1:601 CEDAR ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-1999
Practice Address - Country:US
Practice Address - Phone:252-838-1605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1428103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107712Medicaid
NC046MCOtherBLUE CROSS BLUE SHIELD