Provider Demographics
NPI:1558671693
Name:MAIER, ADRIANE
Entity Type:Individual
Prefix:
First Name:ADRIANE
Middle Name:
Last Name:MAIER
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 1:104 CONE PL
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:NY
Mailing Address - Zip Code:12451-1503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 KUKUK LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6943
Practice Address - Country:US
Practice Address - Phone:845-336-2616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000177-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health