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NPI Code Detail

MEDICARE: RENEE P. COOKSON CTRS

MEDICARE: RENEE P. COOKSON CTRS
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
1101YP2500XProfessional Counselor26024NV

General Provider Information

NPI Number : 1326093121
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE P. COOKSON CTRS
Provider Business Mailing Address
First Line : 5009 HARMONY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2712
Country : US
Telephone Number : 702-870-6778
Fax Number : 702-253-9625
Provider Business Practice Location Address
First Line : 5763 W CHARLESTON BLVD
Second Line : SUITE 100 A
City : LAS VEGAS
State : NV
Zip : 89146-1235
Country : US
Telephone Number : 702-253-0818
Fax Number : 702-253-9625
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 07/09/2007

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Directions to “ RENEE P. COOKSON CTRS” Practice Location

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