MEDICARE: REBECCA EDES

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1184931982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA EDES

Provider Business Mailing Address
First Line	:	7001 W CHARLESTON BLVD
Second Line	:	#1100
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1651
Country	:	US
Telephone Number	:	760-534-3109
Fax Number	:

Provider Business Practice Location Address
First Line	:	7001 W CHARLESTON BLVD
Second Line	:	#1100
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1651
Country	:	US
Telephone Number	:	760-534-3109
Fax Number	:

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

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	09/02/2010

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Directions to “ REBECCA EDES ” Practice Location

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