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NPI Code Detail

MEDICARE: MARYANN CHABOT-FENCE MFT

MEDICARE:   MARYANN  CHABOT-FENCE  MFT
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 Counselor0840NV

General Provider Information

NPI Number : 1710337902
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYANN CHABOT-FENCE MFT
Provider Business Mailing Address
First Line : 5959 SEDGE RD
Second Line :
City : CARSON CITY
State : NV
Zip : 89701-9303
Country : US
Telephone Number : 775-720-8090
Fax Number :
Provider Business Practice Location Address
First Line : 5959 SEDGE RD
Second Line :
City : CARSON CITY
State : NV
Zip : 89701-9303
Country : US
Telephone Number : 775-720-8090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2016
Last Update Date : 06/17/2016

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Directions to “ MARYANN CHABOT-FENCE MFT” Practice Location

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