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NPI Code Detail

MEDICARE: MRS. LYNDA MARION VARGO LMSW

MEDICARE: MRS. LYNDA MARION VARGO LMSW
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 Worker6801084458MI

General Provider Information

NPI Number : 1598807828
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNDA MARION VARGO LMSW
Provider Business Mailing Address
First Line : 1375 R DALE WERTZ DR
Second Line :
City : BAD AXE
State : MI
Zip : 48413-1365
Country : US
Telephone Number : 989-269-9293
Fax Number :
Provider Business Practice Location Address
First Line : 1375 R DALE WERTZ DR
Second Line :
City : BAD AXE
State : MI
Zip : 48413-1365
Country : US
Telephone Number : 989-269-9293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 02/16/2016

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