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NPI Code Detail

MEDICARE: MARYLYN ECKELKAMP MFT

MEDICARE: MARYLYN ECKELKAMP MFT
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
1101YM0800XMental Health Counselor0458NV

General Provider Information

NPI Number : 1306943568
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYLYN ECKELKAMP MFT
Provider Business Mailing Address
First Line : 7200 CATHEDRAL ROCK DR STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0439
Country : US
Telephone Number : 702-341-5888
Fax Number : 702-341-9587
Provider Business Practice Location Address
First Line : 7200 CATHEDRAL ROCK DR STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0439
Country : US
Telephone Number : 702-341-5888
Fax Number : 702-341-9587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/09/2007

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Directions to “ MARYLYN ECKELKAMP MFT” Practice Location

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