MEDICARE: MS. DYAN E WEBB

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	101YM0800X	Mental Health Counselor		NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659814564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DYAN E WEBB

Provider Business Mailing Address
First Line	:	2121 N JONES BLVD
Second Line	:	#206
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-3300
Country	:	US
Telephone Number	:	404-754-2933
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 N JONES BLVD
Second Line	:	#206
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-3300
Country	:	US
Telephone Number	:	404-754-2933
Fax Number	:

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

Provider Enumeration Date	:	11/24/2016
Last Update Date	:	11/24/2016

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