MEDICARE: AFRICA ELVIRA PANNOZZI 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	MFT.LF.70109865	WA

General Provider Information

NPI Number	:	1851140008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFRICA ELVIRA PANNOZZI LMFT

Provider Business Mailing Address
First Line	:	1700 SW MULBERRY PL APT A101
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-7155
Country	:	US
Telephone Number	:	239-850-9353
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 SW MULBERRY PL
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-7155
Country	:	US
Telephone Number	:	239-850-9353
Fax Number	:

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

Provider Enumeration Date	:	05/17/2024
Last Update Date	:	06/05/2026

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