Provider Demographics
NPI:1659636835
Name:MEISTER, ISRAEL TRACEY (MS)
Entity Type:Individual
Prefix:MRS
First Name:ISRAEL
Middle Name:TRACEY
Last Name:MEISTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2289 VAN GOGH DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5031
Mailing Address - Country:US
Mailing Address - Phone:702-236-3868
Mailing Address - Fax:
Practice Address - Street 1:70 E HORIZON RIDGE PKWY
Practice Address - Street 2:130
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-7925
Practice Address - Country:US
Practice Address - Phone:702-998-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist