Provider Demographics
NPI:1114624327
Name:MALACREA, CURTIS R
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:R
Last Name:MALACREA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 ORRCREST DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-8008
Mailing Address - Country:US
Mailing Address - Phone:408-460-5338
Mailing Address - Fax:
Practice Address - Street 1:7285 BLUESTONE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1320
Practice Address - Country:US
Practice Address - Phone:775-391-0363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT3231106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician