Individual
FRED BLAUTH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
2105 SULLIVAN LN, SPARKS, NV 89431
(775) 355-7735
Mailing address
927 MOUNT ROSE ST, RENO, NV 89509-3226
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00130-C
NV
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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