MEDICARE: JUDY WINREB MA, MFT, LADC

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	0716	NV

General Provider Information

NPI Number	:	1598987349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY WINREB MA, MFT, LADC

Provider Business Mailing Address
First Line	:	5940 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2540
Country	:	US
Telephone Number	:	702-362-0860
Fax Number	:	702-835-9301

Provider Business Practice Location Address
First Line	:	5940 S RAINBOW BLVD # D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2540
Country	:	US
Telephone Number	:	702-362-0860
Fax Number	:	702-835-9301

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	04/17/2015

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