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NPI Code Detail

MEDICARE: TERESA KAY MAIB LCSW

MEDICARE:   TERESA KAY MAIB  LCSW
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1568024727
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA KAY MAIB LCSW
Provider Business Mailing Address
First Line : 7282 STINSON AVE STE B
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-4930
Country : US
Telephone Number : 253-857-5447
Fax Number : 253-857-0710
Provider Business Practice Location Address
First Line : 7282 STINSON AVE STE B
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-4930
Country : US
Telephone Number : 253-857-5447
Fax Number : 253-857-0710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2019
Last Update Date : 07/08/2019

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Directions to “ TERESA KAY MAIB LCSW” Practice Location

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