MEDICARE: MIRIAM GEIGER PLLC

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	101Y00000X	Counselor
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1093521627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIRIAM GEIGER PLLC

Provider Business Mailing Address
First Line	:	3112 N NORTH ST
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61604-1564
Country	:	US
Telephone Number	:	341-333-8484
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 N NORTH ST
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61604-1564
Country	:	US
Telephone Number	:	510-684-9063
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MIRIAM RUTH GEIGER
Credential	:	LMFT, LPCC, LCPC
Telephone Number	:	341-333-8484

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	12/09/2024

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