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NPI Code Detail

MEDICARE: LITTLE MUNCHKINS PROFESSIONAL CLINICAL COUNSELOR INC

MEDICARE: LITTLE MUNCHKINS PROFESSIONAL CLINICAL COUNSELOR INC
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1023660867
Entity Type Code : Organization
Provider Name (Legal Business Name) : LITTLE MUNCHKINS PROFESSIONAL CLINICAL COUNSELOR INC
Provider Business Mailing Address
First Line : 1905 PALM AVE
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-1326
Country : US
Telephone Number : 650-405-7022
Fax Number :
Provider Business Practice Location Address
First Line : 1905 PALM AVE
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-1326
Country : US
Telephone Number : 650-405-7022
Fax Number :
Authorized Official
Title or Position : OWNER / FOUNDER
Name : RENEE FINNICUM
Credential : LPCC
Telephone Number : 650-405-7022
Provider Enumeration Date : 07/11/2019
Last Update Date : 07/11/2019

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Directions to “LITTLE MUNCHKINS PROFESSIONAL CLINICAL COUNSELOR INC ” Practice Location

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