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General NPI Number Information
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NPI Number | 1831499722
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Entity Type | Individual
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Provider Name | HEATHER SHAFT
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Gender | Female
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 2655 ENTERPRISE RD FAMILY LEARNING HOME 2
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City | RENO
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State | NV
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Zip | 89512-1666
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Country | US
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Telephone | 775-688-1612
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LENWOOD DR
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City | SPARKS
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State | NV
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Zip | 89431-1365
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Country | US
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Telephone | 775-331-7245
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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