Provider Demographics
NPI:1285119149
Name:DREW, TRISTEN NATEJAH (RBT)
Entity type:Individual
Prefix:
First Name:TRISTEN
Middle Name:NATEJAH
Last Name:DREW
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 PARKCHESTER DR APT A
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-5882
Mailing Address - Country:US
Mailing Address - Phone:775-385-4806
Mailing Address - Fax:
Practice Address - Street 1:1250 LAMOILLE HWY STE 103
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4397
Practice Address - Country:US
Practice Address - Phone:775-777-1292
Practice Address - Fax:775-777-2193
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other