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NPI Code Detail

MEDICARE: ELIZABETH MARIE WEBB RADT1

MEDICARE: ELIZABETH MARIE WEBB RADT1
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 : 1134655947
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARIE WEBB RADT1
Provider Business Mailing Address
First Line : 13525 CIELO AZUL WAY
Second Line :
City : DESERT HOT SPRINGS
State : CA
Zip : 92240-6235
Country : US
Telephone Number : 760-329-4673
Fax Number : 760-329-7311
Provider Business Practice Location Address
First Line : 13525 CIELO AZUL WAY
Second Line :
City : DESERT HOT SPRINGS
State : CA
Zip : 92240-6235
Country : US
Telephone Number : 760-329-4673
Fax Number : 760-329-7311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 05/11/2017

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Directions to “ ELIZABETH MARIE WEBB RADT1” Practice Location

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