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NPI Code Detail

MEDICARE: DR. LENORA M POE PHD

MEDICARE:  DR. LENORA M POE  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistMFT20628CA

General Provider Information

NPI Number : 1013077247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LENORA M POE PHD
Provider Business Mailing Address
First Line : 2034 BLAKE ST
Second Line : #1
City : BERKELEY
State : CA
Zip : 94704
Country : US
Telephone Number : 510-845-7189
Fax Number : 510-845-2330
Provider Business Practice Location Address
First Line : 2034 BLAKE ST
Second Line : #1
City : BERKELEY
State : CA
Zip : 94704
Country : US
Telephone Number : 510-845-7189
Fax Number : 510-845-2330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LENORA M POE PHD” Practice Location

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