MEDICARE: SIA CHAMBERLIN

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	101YS0200X	School Counselor		AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457493553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIA CHAMBERLIN

Provider Business Mailing Address
First Line	:	6720 E CONTINENTAL DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-3226
Country	:	US
Telephone Number	:	480-484-5807
Fax Number	:	480-484-5801

Provider Business Practice Location Address
First Line	:	6720 E CONTINENTAL DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-3226
Country	:	US
Telephone Number	:	480-484-0580
Fax Number	:	480-484-5801

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/26/2007

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1285159111 — MRS. AUTUMN GUINN MERKLEY BSN, RN
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Directions to “ SIA CHAMBERLIN ” Practice Location

Language	Start Address	Practice Location

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