MEDICARE: MR. DANIE; LOUIS REECE JR.

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1649765041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIE; LOUIS REECE JR.

Provider Business Mailing Address
First Line	:	9350 S CIMARRON RD UNIT 1056
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-2512
Country	:	US
Telephone Number	:	702-250-6954
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 E FLAMINGO RD STE 125
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5259
Country	:	US
Telephone Number	:	702-751-4801
Fax Number	:

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

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	06/27/2018

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