MEDICARE: SILKII RENEE FITZHUGH

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	:	1043654353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SILKII RENEE FITZHUGH

Provider Business Mailing Address
First Line	:	1120 INDIAN HEDGE DRIVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032
Country	:	US
Telephone Number	:	702-772-4682
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 INDIAN HEDGE DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7665
Country	:	US
Telephone Number	:	702-772-4682
Fax Number	:

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

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	04/18/2013

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