Individual
SANDRA HYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 GRIMES ST, FALLON, NV 89406-3103
(775) 423-1412
(775) 423-4054
Mailing address
PO BOX 1240, FALLON, NV 89407-1240
(775) 423-1412
(775) 423-4054
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
249
NV
104100000X
Social Worker
4700-S
NV
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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