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NPI Code Detail

MEDICARE: IGOR V DROBUSHEV

MEDICARE:   IGOR V DROBUSHEV
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1962743500
Entity Type Code : Individual
Provider Name (Legal Business Name) : IGOR V DROBUSHEV
Provider Business Mailing Address
First Line : 6430 PEAVINE HILLS AVE
Second Line :
City : RENO
State : NV
Zip : 89523-2867
Country : US
Telephone Number : 775-843-1783
Fax Number :
Provider Business Practice Location Address
First Line : 6430 PEAVINE HILLS AVE
Second Line :
City : RENO
State : NV
Zip : 89523-2867
Country : US
Telephone Number : 775-843-1783
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2013
Last Update Date : 03/06/2013

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Directions to “ IGOR V DROBUSHEV ” Practice Location

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