Provider Demographics
NPI:1255701652
Name:BRUCKLACHER, NORA (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:NORA
Middle Name:
Last Name:BRUCKLACHER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 S CENTER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-2332
Mailing Address - Country:US
Mailing Address - Phone:775-224-0703
Mailing Address - Fax:775-333-9909
Practice Address - Street 1:855 S CENTER ST STE 101
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2332
Practice Address - Country:US
Practice Address - Phone:775-224-0703
Practice Address - Fax:775-333-9909
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0474101YM0800X
NV01444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health