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General NPI Number Information
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NPI Number | 1528208402
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Entity Type | Individual
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Provider Name | MRS. MICHELLE ANN MAGGIANO
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Gender | Female
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Dates
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Enumeration Date | 03/04/2009
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 19231 VICTORY BLVD
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City | RESEDA
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State | CA
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Zip | 91335-6308
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Country | US
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Telephone | 818-755-1766
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Fax |
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Provider Business Mailing Address
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Address Line | 20211 SHERMAN WAY APT.104
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City | WINNETKA
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State | CA
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Zip | 91306-3267
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Country | US
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Telephone | 818-709-4217
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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