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General NPI Number Information
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NPI Number | 1306977913
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Entity Type | Individual
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Provider Name | MARY ANN SPEIGHT LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | 15400 CHOLAME RD
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City | VICTORVILLE
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State | CA
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Zip | 92392-2480
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Country | US
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Telephone | 760-245-4695
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Fax | 760-780-4591
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Provider Business Mailing Address
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Address Line | 14443 PARK AVE STE B-2
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City | VICTORVILLE
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State | CA
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Zip | 92392-2927
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Country | US
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Telephone | 909-529-6205
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Fax | 760-513-9755
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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 | IMF 43081
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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 | MFC51793
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License Number State | CA
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