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NPI Code Detail

MEDICARE: MARSHALL HARRISON GLEDHILL CADC-I

MEDICARE: MARSHALL HARRISON GLEDHILL CADC-I
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
1101YA0400XAddiction (Substance Use Disorder) Counselor06862-INV

General Provider Information

NPI Number : 1447821004
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHALL HARRISON GLEDHILL CADC-I
Provider Business Mailing Address
First Line : 710 HOT SPRINGS RD APT 204
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-0947
Country : US
Telephone Number : 775-530-9424
Fax Number :
Provider Business Practice Location Address
First Line : 119 E LONG ST
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-2505
Country : US
Telephone Number : 775-530-9424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2021
Last Update Date : 10/31/2022

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