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NPI Code Detail

MEDICARE: MS. ANNE MARIE WAMBA MA

MEDICARE:  MS. ANNE MARIE  WAMBA  MA
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 Therapist931MA

General Provider Information

NPI Number : 1316023245
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANNE MARIE WAMBA MA
Provider Business Mailing Address
First Line : 203 LEWIS ST
Second Line : APT#1
City : LYNN
State : MA
Zip : 01902-4863
Country : US
Telephone Number : 781-599-4287
Fax Number :
Provider Business Practice Location Address
First Line : 55 DIMOCK ST
Second Line : COMMUNITY CARE CENTER
City : ROXBURY
State : MA
Zip : 02119-1029
Country : US
Telephone Number : 617-442-8800
Fax Number : 617-442-1702
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 07/08/2007

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Directions to “ MS. ANNE MARIE WAMBA MA” Practice Location

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