MEDICARE: RENEE DOBSON

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	:	1457608960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE DOBSON

Provider Business Mailing Address
First Line	:	PO BOX 34422
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-4422
Country	:	US
Telephone Number	:	856-701-5316
Fax Number	:

Provider Business Practice Location Address
First Line	:	6070 S EASTERN AVE STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3169
Country	:	US
Telephone Number	:	856-701-5316
Fax Number	:

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

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	08/14/2012

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Directions to “ RENEE DOBSON ” Practice Location

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