MEDICARE: AMY HACHQUET LMFTI

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	MI0317	NV

General Provider Information

NPI Number	:	1285002295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HACHQUET LMFTI

Provider Business Mailing Address
First Line	:	3230 S BUFFALO DR
Second Line	:	SUITE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2505
Country	:	US
Telephone Number	:	888-337-4551
Fax Number	:

Provider Business Practice Location Address
First Line	:	3230 S BUFFALO DR
Second Line	:	SUITE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2505
Country	:	US
Telephone Number	:	888-337-4551
Fax Number	:

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

Provider Enumeration Date	:	09/08/2015
Last Update Date	:	09/08/2015

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