Individual
LUCAS ALLAN BROTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LP
Contact information
Practice address
1055 S WELLS AVE, RENO, NV 89502-2550
(775) 329-6300
(775) 348-3896
Mailing address
680 S ROCK BLVD, RENO, NV 89502-4113
(775) 329-6300
(775) 348-3896
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
9716
NE
103T00000X
Psychologist
861
NE
103T00000X
Psychologist
Primary
PYT150330
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100261397-00
—
NE
05
—
10026251000
—
NE
05
—
470376606-24
—
NE
05
—
470376606-31
—
NE
Enumeration date
07/23/2012
Last updated
10/01/2015
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