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NPI Code Detail

MEDICARE: MARY M MARONEY LMFT

MEDICARE: MARY M MARONEY LMFT
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
1106H00000XMarriage & Family Therapist609-124WI

Other Identifiers

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

General Provider Information

NPI Number : 1568503399
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY M MARONEY LMFT
Provider Business Mailing Address
First Line : 2623 S SHORE DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-2321
Country : US
Telephone Number : 414-708-0329
Fax Number :
Provider Business Practice Location Address
First Line : 1524 N FARWELL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53202-2329
Country : US
Telephone Number : 414-273-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 03/23/2009

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