MEDICARE: MAHALEY PATEL LMFT

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

General Provider Information

NPI Number	:	1376181636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHALEY PATEL LMFT

Provider Business Mailing Address
First Line	:	7060 CRIMSON LEAF LN
Second Line	:
City	:	COLLEGE GROVE
State	:	TN
Zip	:	37046-1477
Country	:	US
Telephone Number	:	770-375-0842
Fax Number	:

Provider Business Practice Location Address
First Line	:	7060 CRIMSON LEAF LN
Second Line	:
City	:	COLLEGE GROVE
State	:	TN
Zip	:	37046-1477
Country	:	US
Telephone Number	:	770-375-0842
Fax Number	:

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

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	11/03/2024

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Directions to “ MAHALEY PATEL LMFT” Practice Location

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