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NPI Code Detail

MEDICARE: MARIANNE BISTREK

MEDICARE:   MARIANNE  BISTREK
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1346175999
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNE BISTREK
Provider Business Mailing Address
First Line : 2850 W HORIZON RIDGE PKWY STE 200
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4395
Country : US
Telephone Number : 702-781-0010
Fax Number :
Provider Business Practice Location Address
First Line : 2850 W HORIZON RIDGE PKWY STE 200
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4395
Country : US
Telephone Number : 702-781-0010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ MARIANNE BISTREK ” Practice Location

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