MEDICARE: HORSE PLAY NOW, L.L.C.

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	101YP2500X	Professional Counselor	LPC11993

General Provider Information

NPI Number	:	1467725481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORSE PLAY NOW, L.L.C.

Provider Business Mailing Address
First Line	:	PO BOX 271
Second Line	:	3655 W ANTHEM WAY SUITE A-109
City	:	ANTHEM
State	:	AZ
Zip	:	85086
Country	:	US
Telephone Number	:	602-628-9907
Fax Number	:

Provider Business Practice Location Address
First Line	:	2940 W. JOY RANCH RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086
Country	:	US
Telephone Number	:	602-628-9907
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	MRS. JAMIE ISABELLE WILLIAMS
Credential	:
Telephone Number	:	602-628-9907

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/22/2012

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