Provider Demographics
NPI:1881996890
Name:ROBERTS, LAURIE LEE (QMHA)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:LEE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19935
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2573
Mailing Address - Country:US
Mailing Address - Phone:775-750-9823
Mailing Address - Fax:
Practice Address - Street 1:809 WASHOE DR.
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89704
Practice Address - Country:US
Practice Address - Phone:775-750-9823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner