Healthcare Provider Details

I. General information

NPI: 1093184913
Provider Name (Legal Business Name): MRS. MICHELLE PUFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS MICHELLE RECTOR

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 MILL ST STE 100
RENO NV
89502-1463
US

IV. Provider business mailing address

1074 TURNBERRY DR
SPARKS NV
89436-1819
US

V. Phone/Fax

Practice location:
  • Phone: 775-538-6700
  • Fax:
Mailing address:
  • Phone: 775-772-3986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: