| Doctor Name: | MARILYN DANSESREAU |
| NPI Number: | 1053600684 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | TRN 330120 |
| Business Practice Address: | 1000 C St Hawthorne, NV - 894150012 |
| Business Phone Number: | 7759453368 |
| Business Fax Number: | 7759452307 |
| Mailing Address: | 1665 Old Hot Springs Rd, Suite 157 CARSON CITY |
| State: | NV |
| Postal Code: | 897060782 |
| Phone Number: | 7756875162 |
| Fax Number: | 7756871214 |
| NPI Enumeration Date: | 04/05/2011 |
| NPI Last Update Date: | 04/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | TRN 330120 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |