Healthcare Provider Details

I. General information

NPI: 1720914716
Provider Name (Legal Business Name): MIRANDA NOSSE MFT-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 KIRMAN AVE STE 101
RENO NV
89502-1340
US

IV. Provider business mailing address

1155 MILL ST # M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-3960
  • Fax: 775-982-3727
Mailing address:
  • Phone: 775-982-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMI4721
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: