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NPI Code Detail

MEDICARE: MS. MARYA SUZANNE MAKOWSKI LCSW

MEDICARE: MS. MARYA SUZANNE MAKOWSKI LCSW
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
1104100000XSocial Worker33006734AIN
21041C0700XClinical Social Worker39934TX

General Provider Information

NPI Number : 1740685379
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARYA SUZANNE MAKOWSKI LCSW
Provider Business Mailing Address
First Line : 15800 SEAGOVILLE RD
Second Line :
City : DALLAS
State : TX
Zip : 75253-5703
Country : US
Telephone Number : 972-892-7198
Fax Number : 214-932-7519
Provider Business Practice Location Address
First Line : 15800 SEAGOVILLE RD
Second Line :
City : DALLAS
State : TX
Zip : 75253-5703
Country : US
Telephone Number : 972-892-7198
Fax Number : 765-742-8272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2014
Last Update Date : 09/21/2022

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