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General NPI Number Information
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NPI Number | 1629323555
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Entity Type | Individual
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Provider Name | MIKE F MAGNOTTI MA, LMHC, NCC
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Gender | Male
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | 1127 GRANT RD
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City | EAST WENATCHEE
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State | WA
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Zip | 98802-5242
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Country | US
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Telephone | 509-888-2768
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Fax | 509-888-2768
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Provider Business Mailing Address
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Address Line | 1127 GRANT RD
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City | EAST WENATCHEE
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State | WA
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Zip | 98802-5242
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Country | US
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Telephone | 509-888-2768
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Fax | 509-888-2768
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LH00011112
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License Number State | WA
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