Individual
MACIE SHAY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC-I
Contact information
Practice address
1490 GRIMES ST, FALLON, NV 89406-3103
(775) 423-1490
Mailing address
1490 GRIMES ST, FALLON, NV 89406-3103
(775) 423-1412
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
07251
NV
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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