MEDICARE: MISS LAWONIA GAIL MCGEE

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
1	106H00000X	Marriage & Family Therapist
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1194069252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LAWONIA GAIL MCGEE

Provider Business Mailing Address
First Line	:	2105 N PANNES AVE
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90221-1344
Country	:	US
Telephone Number	:	323-592-6628
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 S. VERMONT AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90007-3846
Country	:	US
Telephone Number	:	323-301-8919
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	06/08/2016

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