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NPI Code Detail

MEDICARE: MARZETTE MCGARY M.DIV.

MEDICARE: MARZETTE MCGARY M.DIV.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1083959910
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARZETTE MCGARY M.DIV.
Provider Business Mailing Address
First Line : 1568 W 36TH PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-4503
Country : US
Telephone Number : 310-999-5756
Fax Number :
Provider Business Practice Location Address
First Line : 1568 W 36TH PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-4503
Country : US
Telephone Number : 310-999-5756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2012
Last Update Date : 12/04/2012

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Directions to “ MARZETTE MCGARY M.DIV.” Practice Location

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