Madelaine C Bodholdt, OTR/L
Individual provider Active NPI Specialist · Reno, NV
NPI 1669798153 · NPPES record last updated Apr 9, 2010
Key facts
- NPI
- 1669798153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 0012 (NV)
- Practice address
- 150 W Huffaker Lane
Ste 105
Reno, NV 89511-2092 - Phone
- (775) 852-4342
- Fax
- (775) 852-9136
- NPI assigned
- Apr 9, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0012 | NV | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0012 | NV | Yes |
Addresses
Primary practice location
150 W Huffaker Lane
Ste 105
Reno, NV 89511-2092
Mailing address
7200 Lingfield Drive
Reno, NV 89502-9661
Phone (775) 857-7854
Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.