Provider Demographics
NPI:1588914154
Name:KOBER, FRED
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:
Last Name:KOBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9145 CEDENO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-5318
Mailing Address - Country:US
Mailing Address - Phone:702-286-7354
Mailing Address - Fax:
Practice Address - Street 1:730 N EASTERN AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-2883
Practice Address - Country:US
Practice Address - Phone:702-772-4864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor