Provider Demographics
NPI:1205255684
Name:SAIN, MARI-LYNN (LMBT)
Entity type:Individual
Prefix:
First Name:MARI-LYNN
Middle Name:
Last Name:SAIN
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 WESSON RD
Mailing Address - Street 2:
Mailing Address - City:VALE
Mailing Address - State:NC
Mailing Address - Zip Code:28168-8631
Mailing Address - Country:US
Mailing Address - Phone:828-443-2245
Mailing Address - Fax:
Practice Address - Street 1:1110 WESSON RD
Practice Address - Street 2:
Practice Address - City:VALE
Practice Address - State:NC
Practice Address - Zip Code:28168-8631
Practice Address - Country:US
Practice Address - Phone:828-443-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12898174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist