MEDICARE: MIRANDA SCHREIBER CPC-I

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CI3003	NV

General Provider Information

NPI Number	:	1164038659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA SCHREIBER CPC-I

Provider Business Mailing Address
First Line	:	5627 STOMPING BOOTS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2076
Country	:	US
Telephone Number	:	412-992-7708
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 SMOKE RANCH RD STE S
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0260
Country	:	US
Telephone Number	:	702-456-4262
Fax Number	:

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

Provider Enumeration Date	:	09/20/2020
Last Update Date	:	09/20/2020

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Directions to “ MIRANDA SCHREIBER CPC-I” Practice Location

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