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NPI Code Detail

MEDICARE: ANNE HERMES MHP

MEDICARE: ANNE HERMES MHP
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 Counselor

General Provider Information

NPI Number : 1780857086
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE HERMES MHP
Provider Business Mailing Address
First Line : 519 E 2ND ST
Second Line :
City : DIXON
State : IL
Zip : 61021-3101
Country : US
Telephone Number : 815-288-6020
Fax Number : 815-284-6905
Provider Business Practice Location Address
First Line : 125 S 4TH ST
Second Line :
City : OREGON
State : IL
Zip : 61061-1609
Country : US
Telephone Number : 815-732-3157
Fax Number : 815-732-3834
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2008
Last Update Date : 04/08/2008

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