MEDICARE: CAMILLE AMOY CADOGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225400000X	Rehabilitation Practitioner
2	101Y00000X	Counselor
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1124229604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE AMOY CADOGAN

Provider Business Mailing Address
First Line	:	4612 EVAN RIDGE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-1624
Country	:	US
Telephone Number	:	702-646-5437
Fax Number	:

Provider Business Practice Location Address
First Line	:	4612 EVAN RIDGE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-1624
Country	:	US
Telephone Number	:	702-646-5437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	01/06/2011

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Directions to “ CAMILLE AMOY CADOGAN ” Practice Location

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