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NPI Code Detail

MEDICARE: MS. ANDREA ELLEN KRUEGER M.ED., MFT

MEDICARE: MS. ANDREA ELLEN KRUEGER M.ED., MFT
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
1106H00000XMarriage & Family Therapist0439NV

General Provider Information

NPI Number : 1649229899
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDREA ELLEN KRUEGER M.ED., MFT
Provider Business Mailing Address
First Line : 2649 W HORIZON RIDGE PKWY
Second Line : SUITE 130
City : HENDERSON
State : NV
Zip : 89052-4801
Country : US
Telephone Number : 702-696-9490
Fax Number : 702-796-9490
Provider Business Practice Location Address
First Line : 2649 W HORIZON RIDGE PKWY
Second Line : SUITE 130
City : HENDERSON
State : NV
Zip : 89052-4801
Country : US
Telephone Number : 702-696-9490
Fax Number : 702-796-9490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 07/08/2007

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