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NPI Code Detail

MEDICARE: MARIE ANTOINE

MEDICARE: MARIE ANTOINE
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 CounselorA20381NC

General Provider Information

NPI Number : 1699590778
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE ANTOINE
Provider Business Mailing Address
First Line : 447 SUTTER ST STE 405
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94108-4618
Country : US
Telephone Number : 415-992-6155
Fax Number : 650-360-6913
Provider Business Practice Location Address
First Line : 1431 ELIZABETH AVE
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-2506
Country : US
Telephone Number : 415-992-6155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2024
Last Update Date : 11/22/2024

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Directions to “ MARIE ANTOINE ” Practice Location

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