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NPI Code Detail

MEDICARE: AMANDA SUSAN BASLER MFT

MEDICARE:   AMANDA SUSAN BASLER  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
1106H00000XMarriage & Family Therapist47101CA

General Provider Information

NPI Number : 1336261320
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA SUSAN BASLER MFT
Provider Business Mailing Address
First Line : 1717 UNION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94123-4406
Country : US
Telephone Number : 415-683-1899
Fax Number : 415-742-4535
Provider Business Practice Location Address
First Line : 1717 UNION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94123-4406
Country : US
Telephone Number : 415-683-1899
Fax Number : 415-742-4535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 08/18/2014

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Directions to “ AMANDA SUSAN BASLER MFT” Practice Location

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