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NPI Code Detail

MEDICARE: RYAN ROONEY VIATOR CADC

MEDICARE:   RYAN ROONEY VIATOR  CADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor07524-CNV

General Provider Information

NPI Number : 1649047853
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN ROONEY VIATOR CADC
Provider Business Mailing Address
First Line : 10701 S EASTERN AVE APT 428
Second Line :
City : HENDERSON
State : NV
Zip : 89052-2991
Country : US
Telephone Number : 702-466-0620
Fax Number :
Provider Business Practice Location Address
First Line : 3050 E DESERT INN RD STE 116
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3872
Country : US
Telephone Number : 702-796-0660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2023
Last Update Date : 12/07/2023

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Directions to “ RYAN ROONEY VIATOR CADC” Practice Location

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