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NPI Code Detail

MEDICARE: PATTI J MCMAHON LPC

MEDICARE: PATTI J MCMAHON LPC
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 CounselorLPC 361WY
2101YM0800XMental Health CounselorC1274OR

General Provider Information

NPI Number : 1679802656
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATTI J MCMAHON LPC
Provider Business Mailing Address
First Line : 748 MAIN ST
Second Line :
City : LANDER
State : WY
Zip : 82520-3036
Country : US
Telephone Number : 307-332-2231
Fax Number : 307-332-9338
Provider Business Practice Location Address
First Line : 748 MAIN ST
Second Line :
City : LANDER
State : WY
Zip : 82520-3036
Country : US
Telephone Number : 307-332-2231
Fax Number : 307-332-9338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2009
Last Update Date : 12/21/2009

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Directions to “ PATTI J MCMAHON LPC” Practice Location

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