Provider Demographics
NPI:1497065288
Name:SWEENEY, DREANA L
Entity Type:Individual
Prefix:
First Name:DREANA
Middle Name:L
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 363173
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89036-7173
Mailing Address - Country:US
Mailing Address - Phone:702-612-0431
Mailing Address - Fax:702-586-9395
Practice Address - Street 1:809 PORT VINCENT AVE
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-2311
Practice Address - Country:US
Practice Address - Phone:702-612-0431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner