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NPI Code Detail

MEDICARE: MARIAN HOUSEL-WATT

MEDICARE: MARIAN HOUSEL-WATT
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
11041C0700XClinical Social WorkerASW 20513CA

General Provider Information

NPI Number : 1730238825
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAN HOUSEL-WATT
Provider Business Mailing Address
First Line : PO BOX 865
Second Line :
City : MEADOW VISTA
State : CA
Zip : 95722-0865
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 24077 STATE HIGHWAY 49
Second Line :
City : NEVADA CITY
State : CA
Zip : 95959-8519
Country : US
Telephone Number : 530-265-9057
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 07/08/2007

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