MEDICARE: TARA DOURIS MS

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	106H00000X	Marriage & Family Therapist	M14270	NV
2	106H00000X	Marriage & Family Therapist	MI4270	NV

General Provider Information

NPI Number	:	1528837077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA DOURIS MS

Provider Business Mailing Address
First Line	:	2431 W HORIZON RIDGE PKWY STE 110
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5783
Country	:	US
Telephone Number	:	702-472-7199
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 SAINT ROSE PKWY STE 221
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7789
Country	:	US
Telephone Number	:	702-472-7199
Fax Number	:

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

Provider Enumeration Date	:	12/26/2023
Last Update Date	:	01/20/2026

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Directions to “ TARA DOURIS MS” Practice Location

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