MEDICARE: JOY MARIE RABON L.M.F.T.

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	1337	NC
2	106H00000X	Marriage & Family Therapist	419	AL

General Provider Information

NPI Number	:	1265791164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY MARIE RABON L.M.F.T.

Provider Business Mailing Address
First Line	:	702 N ENGLEWOOD AVE
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-2582
Country	:	US
Telephone Number	:	828-268-3849
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 N ENGLEWOOD AVE
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-2582
Country	:	US
Telephone Number	:	828-268-3849
Fax Number	:

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

Provider Enumeration Date	:	05/11/2012
Last Update Date	:	03/14/2022

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