Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1265780498 |
---|---|
Provider Name | Dennis Reagan |
First Address | Reno, NV 89502-7117 |
Second Address | Reno, NV 89502-7117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2012 |
Last Update Date | 20/08/2012 |