MEDICARE: MR. NICK JONATHAN TAPIE LMFT

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
1	106H00000X	Marriage & Family Therapist	201104	TX

General Provider Information

NPI Number	:	1043519143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICK JONATHAN TAPIE LMFT

Provider Business Mailing Address
First Line	:	1217 E SOUTH 11TH ST STE A
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79602-4252
Country	:	US
Telephone Number	:	325-518-0854
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 E SOUTH 11TH ST STE A
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79602-4252
Country	:	US
Telephone Number	:	325-518-0854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2011
Last Update Date	:	03/15/2011

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