MEDICARE: MS. MARION RICHTER MSW, LCSW, BCD

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	1041C0700X	Clinical Social Worker	SW5292	FL

General Provider Information

NPI Number	:	1659343135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARION RICHTER MSW, LCSW, BCD

Provider Business Mailing Address
First Line	:	10000 BAY PINES BLVD
Second Line	:
City	:	BAY PINES
State	:	FL
Zip	:	33744-5005
Country	:	US
Telephone Number	:	727-398-6661
Fax Number	:

Provider Business Practice Location Address
First Line	:	10000 BAY PINES BLVD
Second Line	:
City	:	BAY PINES
State	:	FL
Zip	:	33744-5005
Country	:	US
Telephone Number	:	727-398-6661
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	06/08/2010

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