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NPI Code Detail

MEDICARE: RAYANA DENEE BROOKSHER

MEDICARE: RAYANA DENEE BROOKSHER
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 : 1528669868
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYANA DENEE BROOKSHER
Provider Business Mailing Address
First Line : 611 VILLAGE DR
Second Line :
City : FERNLEY
State : NV
Zip : 89408-8730
Country : US
Telephone Number : 775-247-7527
Fax Number :
Provider Business Practice Location Address
First Line : 150 E MAIN ST STE 430
Second Line :
City : FERNLEY
State : NV
Zip : 89408-7744
Country : US
Telephone Number : 209-505-0634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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Directions to “ RAYANA DENEE BROOKSHER ” Practice Location

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