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NPI Code Detail

MEDICARE: MARITA L TEMPLE LPC

MEDICARE: MARITA L TEMPLE LPC
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
1101YM0800XMental Health CounselorC.2204444OH

General Provider Information

NPI Number : 1619686359
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARITA L TEMPLE LPC
Provider Business Mailing Address
First Line : 6312 W BANCROFT ST APT 6
Second Line :
City : TOLEDO
State : OH
Zip : 43615-3244
Country : US
Telephone Number : 419-320-3714
Fax Number :
Provider Business Practice Location Address
First Line : 1070 COMMERCE DR STE 101
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5231
Country : US
Telephone Number : 419-482-8382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2022
Last Update Date : 11/22/2022

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Directions to “ MARITA L TEMPLE LPC” Practice Location

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