Healthcare Provider Details

I. General information

NPI: 1932488459
Provider Name (Legal Business Name): MS. MARLA JEAN EMERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 W 7TH ST
RENO NV
89503-3106
US

IV. Provider business mailing address

3445 W 7TH ST
RENO NV
89503-3106
US

V. Phone/Fax

Practice location:
  • Phone: 775-787-1856
  • Fax: 775-322-4460
Mailing address:
  • Phone: 775-787-1856
  • Fax: 775-322-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: