Provider Demographics
NPI:1891132163
Name:MUSSER, TAMARA SHANNON (CADC)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:SHANNON
Last Name:MUSSER
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:
Other - Last Name:MUSSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC
Mailing Address - Street 1:415 US HIGHWAY 95A S
Mailing Address - Street 2:SUITE E-501
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-9261
Mailing Address - Country:US
Mailing Address - Phone:775-575-6191
Mailing Address - Fax:775-575-6191
Practice Address - Street 1:415 US HIGHWAY 95A S
Practice Address - Street 2:SUITE E-501
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9261
Practice Address - Country:US
Practice Address - Phone:775-575-6191
Practice Address - Fax:775-575-6191
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCADC #00281101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)