MEDICARE: MR. WILLIAM E MABEN

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

General Provider Information

NPI Number	:	1518337146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM E MABEN

Provider Business Mailing Address
First Line	:	16 PALADIAN WAY
Second Line	:
City	:	FORT MITCHELL
State	:	AL
Zip	:	36856-2803
Country	:	US
Telephone Number	:	931-338-5522
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 PALADIAN WAY
Second Line	:
City	:	FORT MITCHELL
State	:	AL
Zip	:	36856-2803
Country	:	US
Telephone Number	:	931-338-5522
Fax Number	:

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

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	09/24/2015

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Directions to “ MR. WILLIAM E MABEN ” Practice Location

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