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NPI Code Detail

MEDICARE: TERESA VISPO-CUBA LMFT

MEDICARE: TERESA VISPO-CUBA LMFT
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
1106H00000XMarriage & Family TherapistLF00001706WA

General Provider Information

NPI Number : 1972086742
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA VISPO-CUBA LMFT
Provider Business Mailing Address
First Line : 3808 S ANGELINE ST
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1712
Country : US
Telephone Number : 206-461-4880
Fax Number : 206-461-6989
Provider Business Practice Location Address
First Line : 3808 S ANGELINE ST
Second Line :
City : SEATTLE
State : WA
Zip : 98118-1712
Country : US
Telephone Number : 206-461-4880
Fax Number : 206-461-6989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2018
Last Update Date : 09/07/2018

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Directions to “ TERESA VISPO-CUBA LMFT” Practice Location

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