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NPI Code Detail

MEDICARE: ADRIENNE PATTERSON

MEDICARE: ADRIENNE PATTERSON
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
1175T00000XPeer SpecialistNV
2106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1164922415
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIENNE PATTERSON
Provider Business Mailing Address
First Line : 6905 BEACH NEST AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-1172
Country : US
Telephone Number : 702-493-5647
Fax Number :
Provider Business Practice Location Address
First Line : 1380 E SILVERADO RANCH BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-5924
Country : US
Telephone Number : 702-491-1265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2018
Last Update Date : 02/13/2018

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Directions to “ ADRIENNE PATTERSON ” Practice Location

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