MEDICARE: MS. KATHERINE MARY MAYHEW 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
1	106H00000X	Marriage & Family Therapist	0737	NV

General Provider Information

NPI Number	:	1578633400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE MARY MAYHEW LMFT

Provider Business Mailing Address
First Line	:	7944 SAGEBRUSH BEND ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3028
Country	:	US
Telephone Number	:	702-217-9989
Fax Number	:

Provider Business Practice Location Address
First Line	:	7371 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1575
Country	:	US
Telephone Number	:	702-217-9989
Fax Number	:

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	04/29/2017

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