Basic Information
| Provider Information | |||||||||
| NPI: | 1588186506 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABROTT | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | MELISSA | ||||||||
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| Credential: | CADC, INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 619 ELKO AVE | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895123414 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 205 S PRATT AVE | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897014730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758823945 | ||||||||
| FaxNumber: | 7758826126 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2017 | ||||||||
| LastUpdateDate: | 07/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | 02138-I | NV | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.