MEDICARE: MS. TRICIA RIET PALMA M.S.

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1063610095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRICIA RIET PALMA M.S.

Provider Business Mailing Address
First Line	:	21005 88TH RD
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-2216
Country	:	US
Telephone Number	:	804-241-3864
Fax Number	:	804-241-3864

Provider Business Practice Location Address
First Line	:	333 PARK AVE S APT 3D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-2922
Country	:	US
Telephone Number	:	212-388-1903
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	07/11/2007

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