Organization
MAPLE STAR NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MARIE GROVES (THERAPIST INTERN)
(775) 677-2216
Entity
Organization
Contact information
Practice address
4773 CAUGHLIM PKWY, SUITE 2, RENO, NV 89519
(775) 677-2216
Mailing address
4773 CAUGHLIN PKWY, SUITE 2, RENO, NV 89519-1011
(775) 677-2216
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MI0550
NV
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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