MEDICARE: BRETT SNELL

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1184394322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT SNELL

Provider Business Mailing Address
First Line	:	3785 E SUNSET RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-6259
Country	:	US
Telephone Number	:	602-561-2534
Fax Number	:

Provider Business Practice Location Address
First Line	:	3785 E SUNSET RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-6259
Country	:	US
Telephone Number	:	602-561-2534
Fax Number	:

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

Provider Enumeration Date	:	09/19/2021
Last Update Date	:	01/19/2023

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Directions to “ BRETT SNELL ” Practice Location

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