MEDICARE: VIOLA NUNGARY LTD

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	CA MFT 31975	CA

General Provider Information

NPI Number	:	1538286570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIOLA NUNGARY LTD

Provider Business Mailing Address
First Line	:	PO BOX 13279
Second Line	:
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96151-3279
Country	:	US
Telephone Number	:	530-542-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2489 LAKE TAHOE BLVD
Second Line	:	SUITE 26
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96150-7728
Country	:	US
Telephone Number	:	530-542-0800
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. VIOLA E. NUNGARY
Credential	:	MFT
Telephone Number	:	530-542-0800

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	12/16/2011

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