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General NPI Number Information
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NPI Number | 1871897470
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Entity Type | Organization
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Legal Business Name | SIERRA HOLISTIC COUNSELOR
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 835 ROCK BLVD
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City | SPARKS
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State | NV
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Zip | 89431-4361
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Country | US
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Telephone | 775-772-2064
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 CANYON CREEK RD
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City | RENO
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State | NV
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Zip | 89523-1703
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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 | GINA MAUREEN FLORES-O'TOOLE
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Credential | ED.S., LADC, LMFT-I
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Telephone | 775-772-2064
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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 | MI-0168
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1260
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License Number State | NV
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