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NPI Code Detail

MEDICARE: DEBORA TRETIAK M.S.

MEDICARE: DEBORA TRETIAK M.S.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor01090-LNV
2106H00000XMarriage & Family Therapist01015NV

General Provider Information

NPI Number : 1235177551
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORA TRETIAK M.S.
Provider Business Mailing Address
First Line : 9402 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-8312
Country : US
Telephone Number : 702-644-6463
Fax Number : 702-254-1216
Provider Business Practice Location Address
First Line : 9402 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-8312
Country : US
Telephone Number : 702-644-6463
Fax Number : 702-254-1216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 10/26/2007

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Directions to “ DEBORA TRETIAK M.S.” Practice Location

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