Healthcare Provider Details

I. General information

NPI: 1750996799
Provider Name (Legal Business Name): MARI ELAINE DEMERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 MILL ST STE 401
RENO NV
89502-1562
US

IV. Provider business mailing address

890 MILL ST STE 401
RENO NV
89502-1562
US

V. Phone/Fax

Practice location:
  • Phone: 775-538-6700
  • Fax: 775-688-5878
Mailing address:
  • Phone: 775-538-6700
  • Fax: 775-688-5878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: