Provider Demographics
NPI:1629620976
Name:DEL MARILLAC COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:DEL MARILLAC COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUNIESKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUG
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-614-6006
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-0142
Mailing Address - Country:US
Mailing Address - Phone:603-614-6006
Mailing Address - Fax:855-614-4325
Practice Address - Street 1:35 HIGH ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-6116
Practice Address - Country:US
Practice Address - Phone:603-614-6006
Practice Address - Fax:855-614-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health