MEDICARE: VICTORIA M BUTLER

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	:	1710261391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA M BUTLER

Provider Business Mailing Address
First Line	:	3331 INDIAN HORSE CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2463
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3331 INDIAN HORSE CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2463
Country	:	US
Telephone Number	:	702-686-6745
Fax Number	:

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

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	09/30/2011

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Directions to “ VICTORIA M BUTLER ” Practice Location

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