MEDICARE: MS. ERIKA ANNE ABRAHAMSSON M.DIV. LMFT

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	106H00000X	Marriage & Family Therapist	1140	MA

General Provider Information

NPI Number	:	1770646929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIKA ANNE ABRAHAMSSON M.DIV. LMFT

Provider Business Mailing Address
First Line	:	1234 BROADWAY
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02144-1703
Country	:	US
Telephone Number	:	617-996-9261
Fax Number	:	781-643-4732

Provider Business Practice Location Address
First Line	:	1234 BROADWAY
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02144-1703
Country	:	US
Telephone Number	:	617-996-9261
Fax Number	:	781-643-4732

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	09/24/2012

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