MEDICARE: MRS. DENA RACHEL JOHNS M.A, MFT

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	0822	NV

General Provider Information

NPI Number	:	1508072141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENA RACHEL JOHNS M.A, MFT

Provider Business Mailing Address
First Line	:	4021 FREEL PEAK CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-3674
Country	:	US
Telephone Number	:	702-339-1087
Fax Number	:

Provider Business Practice Location Address
First Line	:	6877 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1600
Country	:	US
Telephone Number	:	702-339-1087
Fax Number	:

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/01/2013

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