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NPI Code Detail

MEDICARE: MRS. MARILYN MARIE ADAMS LMFT

MEDICARE: MRS. MARILYN MARIE ADAMS 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 TherapistMFC 37301CA

General Provider Information

NPI Number : 1255543732
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARILYN MARIE ADAMS LMFT
Provider Business Mailing Address
First Line : PO BOX 366
Second Line :
City : ATWOOD
State : CA
Zip : 92811-0366
Country : US
Telephone Number : 714-813-3859
Fax Number :
Provider Business Practice Location Address
First Line : 228 W MAIN ST
Second Line :
City : TUSTIN
State : CA
Zip : 92780-4320
Country : US
Telephone Number : 714-813-3859
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 07/08/2007

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