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NPI Code Detail

MEDICARE: MICHAL LANESSA MAGEE

MEDICARE:   MICHAL LANESSA MAGEE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1487278651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAL LANESSA MAGEE
Provider Business Mailing Address
First Line : 1020 E AVENUE R APT 204
Second Line :
City : PALMDALE
State : CA
Zip : 93550-1958
Country : US
Telephone Number : 661-416-9655
Fax Number :
Provider Business Practice Location Address
First Line : 626 W LANCASTER BLVD # 52
Second Line :
City : LANCASTER
State : CA
Zip : 93534-3108
Country : US
Telephone Number : 661-258-3211
Fax Number : 855-568-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2020
Last Update Date : 09/08/2022

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Directions to “ MICHAL LANESSA MAGEE ” Practice Location

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