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General NPI Number Information
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NPI Number | 1275607665
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Entity Type | Individual
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Provider Name | VIOLA ELIZABETH NUNGARY M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2489 HWY 50 SUITE 26
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150
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Country | US
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Telephone | 530-542-0800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13279
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96151-3279
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Country | US
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Telephone | 530-542-0800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC31975
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT0671
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License Number State | NV
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