Provider Demographics
NPI:1578620910
Name:LACOUR, MARY ANNE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:M
Last Name:LACOUR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:614 LOVEVILLE RD STE F1A
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-1623
Mailing Address - Country:US
Mailing Address - Phone:302-234-9447
Mailing Address - Fax:302-234-8984
Practice Address - Street 1:614 LOVEVILLE RD STE F1A
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-1623
Practice Address - Country:US
Practice Address - Phone:302-234-9447
Practice Address - Fax:302-235-8984
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
DEB1-0000566103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling