MEDICARE: MISS MIA FRANCESCA SAMBATARO CERTIFIED COUNSELOR

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1255689378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MIA FRANCESCA SAMBATARO CERTIFIED COUNSELOR

Provider Business Mailing Address
First Line	:	4501 N FOXGLOVE DR NW
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-9044
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5727 BAKER WAY NW STE 101
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-5811
Country	:	US
Telephone Number	:	253-358-3347
Fax Number	:	253-358-3347

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

Provider Enumeration Date	:	08/21/2012
Last Update Date	:	08/21/2012

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