MEDICARE: HILARY WESTROM M.F.T.

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	106H00000X	Marriage & Family Therapist	0942	NV

General Provider Information

NPI Number	:	1538491600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILARY WESTROM M.F.T.

Provider Business Mailing Address
First Line	:	2921 N TENAYA WAY
Second Line	:	SUITE 119
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1409
Country	:	US
Telephone Number	:	702-838-0015
Fax Number	:	702-838-9936

Provider Business Practice Location Address
First Line	:	2921 N TENAYA WAY
Second Line	:	SUITE 119
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1409
Country	:	US
Telephone Number	:	702-838-0015
Fax Number	:	702-838-9936

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

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	02/01/2010

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