MEDICARE: MS. BRIE ANN ARNETTE LMFT, CADC III

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	07-R-10	OR
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	0726	NV
3	106H00000X	Marriage & Family Therapist	T0572	OR
4	106H00000X	Marriage & Family Therapist	0852	NV

General Provider Information

NPI Number	:	1245502574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRIE ANN ARNETTE LMFT, CADC III

Provider Business Mailing Address
First Line	:	19916 HOLLYGRAPE ST
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-2575
Country	:	US
Telephone Number	:	775-762-2743
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 SW WILSON AVE
Second Line	:	SUITE 201
City	:	BEND
State	:	OR
Zip	:	97702-2988
Country	:	US
Telephone Number	:	541-382-8862
Fax Number	:

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

Provider Enumeration Date	:	02/01/2012
Last Update Date	:	02/01/2012

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