Healthcare Provider Details

I. General information

NPI: 1194659805
Provider Name (Legal Business Name): ESTELL NONE MYERS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6165 RIDGEVIEW CT STE F
RENO NV
89519-6332
US

IV. Provider business mailing address

11840 DEODAR WAY
RENO NV
89506-7905
US

V. Phone/Fax

Practice location:
  • Phone: 775-225-5390
  • Fax:
Mailing address:
  • Phone: 775-225-5390
  • Fax: 775-225-5390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number6362
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: