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NPI Code Detail

MEDICARE: EDUCATIONAL AND PSYCHOLOGICAL SERVICES

MEDICARE: EDUCATIONAL AND PSYCHOLOGICAL SERVICES
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
1251B00000XCase Management AgencyLH 00011315WA

General Provider Information

NPI Number : 1891064606
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDUCATIONAL AND PSYCHOLOGICAL SERVICES
Provider Business Mailing Address
First Line : 629 6TH ST
Second Line :
City : CLARKSTON
State : WA
Zip : 99403-2010
Country : US
Telephone Number : 509-758-9698
Fax Number :
Provider Business Practice Location Address
First Line : 629 6TH ST
Second Line :
City : CLARKSTON
State : WA
Zip : 99403-2010
Country : US
Telephone Number : 509-758-9698
Fax Number :
Authorized Official
Title or Position : PHD
Name : JAROD JOHN FITZGERALD
Credential :
Telephone Number : 509-758-9698
Provider Enumeration Date : 12/22/2011
Last Update Date : 12/22/2011

Similar Medicare Providers

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1437349107 — JIL MARIE TAYLOR LMSW
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1710322755 — FITZGERALD PSYCHOLOGICAL SERVICES, P.S.
Practice Location Address:
629 6TH ST
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99403-2010
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Practice Fax: 509-758-9664

Directions to “EDUCATIONAL AND PSYCHOLOGICAL SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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