MEDICARE: ARIELLE GAINSBURG OTR

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	225X00000X	Occupational Therapist	0541	NV

General Provider Information

NPI Number	:	1376757492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIELLE GAINSBURG OTR

Provider Business Mailing Address
First Line	:	10305 FROSTBURG LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-5111
Country	:	US
Telephone Number	:	702-250-6040
Fax Number	:	702-776-6146

Provider Business Practice Location Address
First Line	:	10305 FROSTBURG LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-5111
Country	:	US
Telephone Number	:	702-250-6040
Fax Number	:	702-776-6146

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	02/21/2017

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