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2775 S Jones Blvd 101 Las Vegas NV 89146-5631 | |
| (702) 326-5390 | |
| (702) 586-3333 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2775 S Jones Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Angela Mcguire (CREDENTIALING/ BILLER) |
| Authorized Official Contact | 7027767732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2775 S Jones Blvd 101 Las Vegas NV 89146-5631 Ph: (702) 326-5390 | 2775 S Jones Blvd 101 Las Vegas NV 89146-5631 Ph: (702) 326-5390 |
| NPI Number | 1730439449 |
|---|---|
| Provider Enumeration Date | 09/11/2012 |
| Last Update Date | 09/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730439449 | NPI | - | NPPES |
| PY 0540 | Other | NV | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY0540 (Nevada) | Primary |
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