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NPI Code Detail

MEDICARE: MRS. MARNI MARIE LAHTI MA, MSE

MEDICARE: MRS. MARNI MARIE LAHTI MA, MSE
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
1103T00000XPsychologistAZ

General Provider Information

NPI Number : 1063561892
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARNI MARIE LAHTI MA, MSE
Provider Business Mailing Address
First Line : 9010 W CAMINO DE ORO
Second Line :
City : PEORIA
State : AZ
Zip : 85383-1414
Country : US
Telephone Number : 623-376-7623
Fax Number :
Provider Business Practice Location Address
First Line : 15802 NORTH PARKVIEW PLACE
Second Line :
City : SURPRISE
State : AZ
Zip : 85374-7466
Country : US
Telephone Number : 623-876-7022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/26/2007

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