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NPI Code Detail

MEDICARE: MYRNA HARPER HARTLEY MFT

MEDICARE:   MYRNA HARPER HARTLEY  MFT
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 TherapistMFC15325CA

General Provider Information

NPI Number : 1215013107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRNA HARPER HARTLEY MFT
Provider Business Mailing Address
First Line : 20100 ALLENTOWN DR.
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91364
Country : US
Telephone Number : 818-716-9373
Fax Number : 818-716-9373
Provider Business Practice Location Address
First Line : 20100 ALLENTOWN DR
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91364-3511
Country : US
Telephone Number : 818-716-9373
Fax Number : 818-716-9373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 07/08/2007

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