MEDICARE: MARGARET ANNE HOSMER PHD LLP CACI NCGCII

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	103T00000X	Psychologist	6301006961	MI

General Provider Information

NPI Number	:	1528288321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET ANNE HOSMER PHD LLP CACI NCGCII

Provider Business Mailing Address
First Line	:	3448 LAKE LANSING ROAD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823
Country	:	US
Telephone Number	:	517-333-4440
Fax Number	:	517-333-7173

Provider Business Practice Location Address
First Line	:	3448 LAKE LANSING ROAD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823
Country	:	US
Telephone Number	:	517-333-4440
Fax Number	:	517-333-7173

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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