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NPI Code Detail

MEDICARE: MADELINE DRENNEN

MEDICARE:   MADELINE  DRENNEN
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
1106S00000XBehavior Technician
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1053068353
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE DRENNEN
Provider Business Mailing Address
First Line : PO BOX 8344
Second Line :
City : SPOKANE
State : WA
Zip : 99203-0344
Country : US
Telephone Number : 509-995-3388
Fax Number :
Provider Business Practice Location Address
First Line : 4202 S REGAL ST
Second Line :
City : SPOKANE
State : WA
Zip : 99223-7738
Country : US
Telephone Number : 509-789-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2022
Last Update Date : 04/02/2024

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Directions to “ MADELINE DRENNEN ” Practice Location

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