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NPI Code Detail

MEDICARE: AMANDA M MORIN

MEDICARE: AMANDA M MORIN
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
1101YM0800XMental Health CounselorPLPC7504LA

General Provider Information

NPI Number : 1558857342
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA M MORIN
Provider Business Mailing Address
First Line : 2802 HODGES ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-7368
Country : US
Telephone Number : 337-419-1873
Fax Number : 337-656-2848
Provider Business Practice Location Address
First Line : 2802 HODGES ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-7368
Country : US
Telephone Number : 337-419-1873
Fax Number : 337-656-2848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2018
Last Update Date : 07/05/2018

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Directions to “ AMANDA M MORIN ” Practice Location

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