Provider Demographics
NPI:1144697798
Name:MACEDONIA, MARIE (PSYD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:MACEDONIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:MACEDONIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:7 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-889-6147
Mailing Address - Fax:603-883-1568
Practice Address - Street 1:440 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-883-1568
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 103T00000X
NH103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor