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General NPI Number Information
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NPI Number | 1700641180
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Entity Type | Organization
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Legal Business Name | RENO THERAPY LLC
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 527 PLUMAS ST
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City | RENO
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State | NV
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Zip | 89509-1630
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Country | US
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Telephone | 775-984-8644
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Fax |
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Provider Business Mailing Address
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Address Line | 527 PLUMAS ST
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City | RENO
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State | NV
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Zip | 89509-1630
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDRA SHRAKE
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Credential | PHD
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Telephone | 775-984-8644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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