Provider Demographics
NPI:1760921001
Name:GORIN, ANDREA
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:GORIN
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 1:255 W MOANA LN
Mailing Address - Street 2:STE 104
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 W MOANA LN
Practice Address - Street 2:STE 104
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4906
Practice Address - Country:US
Practice Address - Phone:775-525-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist