MEDICARE: DR. MARIAN M. ORR PROF LLC

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	2084P0800X	Psychiatry Physician	DO1447	NV

General Provider Information

NPI Number	:	1659608156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MARIAN M. ORR PROF LLC

Provider Business Mailing Address
First Line	:	2340 PASEO DEL PRADO STE D307
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4342
Country	:	US
Telephone Number	:	702-222-1812
Fax Number	:	702-222-1786

Provider Business Practice Location Address
First Line	:	2340 PASEO DEL PRADO STE D307
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4342
Country	:	US
Telephone Number	:	702-222-1812
Fax Number	:	702-222-1786

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MARIAN M. ORR
Credential	:
Telephone Number	:	702-222-1812

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	11/05/2009

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