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NPI Code Detail

MEDICARE: MARIANA POLITTE MA, LPC, NCC

MEDICARE: MARIANA POLITTE MA, LPC, NCC
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
1101YP2500XProfessional Counselor2006005203MO

General Provider Information

NPI Number : 1598270084
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA POLITTE MA, LPC, NCC
Provider Business Mailing Address
First Line : 111 MEXICO CT
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-5102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 MEXICO CT
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-5102
Country : US
Telephone Number : 636-723-8482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2017
Last Update Date : 12/06/2017

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