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General NPI Number Information
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NPI Number | 1205210879
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Entity Type | Organization
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Legal Business Name | BALANCE THERAPY CENTER LLC
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 556 CALIFORNIA AVE
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City | RENO
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State | NV
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Zip | 89509-1450
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Country | US
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Telephone | 775-682-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 556 CALIFORNIA AVE
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City | RENO
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State | NV
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Zip | 89509-1450
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Country | US
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Telephone | 775-682-0090
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | DEBBIE RASMUSSEN
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Credential | MFT
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Telephone | 775-682-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 01042
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License Number State | NV
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