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NPI Code Detail

MEDICARE: MARI CHRISTIAN WARD

MEDICARE: MARI CHRISTIAN WARD
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 TherapistT-CTL0211701NM

General Provider Information

NPI Number : 1619595063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARI CHRISTIAN WARD
Provider Business Mailing Address
First Line : 755 S TELSHOR BLVD STE Q102
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4681
Country : US
Telephone Number : 575-888-4666
Fax Number : 575-473-9160
Provider Business Practice Location Address
First Line : 755 S TELSHOR BLVD STE Q102
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4681
Country : US
Telephone Number : 575-888-4666
Fax Number : 575-473-9160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2020
Last Update Date : 07/13/2020

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Directions to “ MARI CHRISTIAN WARD ” Practice Location

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