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NPI Code Detail

MEDICARE: ERICA COVER MA, LMFT

MEDICARE: ERICA COVER MA, 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
1106H00000XMarriage & Family Therapist10261AZ

General Provider Information

NPI Number : 1124296751
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA COVER MA, LMFT
Provider Business Mailing Address
First Line : 34975 N NORTH VALLEY PKWY STE 152
Second Line :
City : PHOENIX
State : AZ
Zip : 85086-4032
Country : US
Telephone Number : 623-889-3400
Fax Number : 623-889-3399
Provider Business Practice Location Address
First Line : 34975 N NORTH VALLEY PKWY STE 152
Second Line :
City : PHOENIX
State : AZ
Zip : 85086-4032
Country : US
Telephone Number : 623-889-3400
Fax Number : 623-889-3399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2008
Last Update Date : 02/17/2008

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