MEDICARE: MS. KIRA MICHELE OHM M.A.

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1821010885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIRA MICHELE OHM M.A.

Provider Business Mailing Address
First Line	:	650 HOWE AVE
Second Line	:	BUILDING -400-A
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-4731
Country	:	US
Telephone Number	:	916-441-0123
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 HOWE AVE
Second Line	:	BUILDING -400-A
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-4731
Country	:	US
Telephone Number	:	916-441-0123
Fax Number	:

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	01/30/2017

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