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NPI Code Detail

MEDICARE: RICHARD VANDE VOORT

MEDICARE: RICHARD VANDE VOORT
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
1106H00000XMarriage & Family Therapist521NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1521OTHERNVMFT

General Provider Information

NPI Number : 1386794865
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD VANDE VOORT
Provider Business Mailing Address
First Line : 9402 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-8312
Country : US
Telephone Number : 702-870-0882
Fax Number : 702-354-9666
Provider Business Practice Location Address
First Line : 9402 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-8312
Country : US
Telephone Number : 702-870-0882
Fax Number : 702-354-9666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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Directions to “ RICHARD VANDE VOORT ” Practice Location

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