MEDICARE: ANNETTE LOVE

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	101YP2500X	Professional Counselor	180.007689	IL
2	101YP2500X	Professional Counselor	LPCC10742	CA
3	101YP2500X	Professional Counselor	CP1067	NV

General Provider Information

NPI Number	:	1245561562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNETTE LOVE

Provider Business Mailing Address
First Line	:	7500 W LAKE MEAD BLVD
Second Line	:	9-381
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0297
Country	:	US
Telephone Number	:	702-587-3196
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 W. LAKE MEAD BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-6616
Country	:	US
Telephone Number	:	702-587-3196
Fax Number	:

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

Provider Enumeration Date	:	01/26/2010
Last Update Date	:	01/06/2023

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Directions to “ ANNETTE LOVE ” Practice Location

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