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NPI Code Detail

MEDICARE: TAMARA SHANNON MUSSER CADC

MEDICARE: TAMARA SHANNON MUSSER 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) CounselorCADC #00281NV

General Provider Information

NPI Number : 1891132163
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA SHANNON MUSSER CADC
Provider Business Mailing Address
First Line : 415 US HIGHWAY 95A S
Second Line : SUITE E-501
City : FERNLEY
State : NV
Zip : 89408-9261
Country : US
Telephone Number : 775-575-6191
Fax Number : 775-575-6191
Provider Business Practice Location Address
First Line : 415 US HIGHWAY 95A S
Second Line : SUITE E-501
City : FERNLEY
State : NV
Zip : 89408-9261
Country : US
Telephone Number : 775-575-6191
Fax Number : 775-575-6191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2013
Last Update Date : 05/28/2013

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Directions to “ TAMARA SHANNON MUSSER CADC” Practice Location

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