Provider Demographics
NPI:1801008222
Name:BINGHAM NEWMAN, ANN MARIE (MFCT)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:BINGHAM NEWMAN
Suffix:
Gender:F
Credentials:MFCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1963 PEMBROKE CT
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2831
Mailing Address - Country:US
Mailing Address - Phone:909-624-3355
Mailing Address - Fax:
Practice Address - Street 1:1963 PEMBROKE CT
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2831
Practice Address - Country:US
Practice Address - Phone:909-624-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMI 19308106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist