Healthcare Provider Details

I. General information

NPI: 1841505682
Provider Name (Legal Business Name): ANNA C TREACY MPH, CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BODY RECLAMATION PROJECT

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 HILL ST #1
RENO NV
89501-1821
US

IV. Provider business mailing address

PO BOX 34707
RENO NV
89533-4707
US

V. Phone/Fax

Practice location:
  • Phone: 775-750-8600
  • Fax:
Mailing address:
  • Phone: 775-750-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number13065
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number13065
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: