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2480 E Tompkins Ave Ste 201 Las Vegas NV 89121-7394 | |
| (725) 305-1192 | |
| (248) 294-1408 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2480 E Tompkins Ave Ste 201, Las Vegas, Nevada |
| Authorized Official Name and Position | Susie Mireles (MANAGER) |
| Authorized Official Contact | 7026305740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2480 E Tompkins Ave Ste 201 Las Vegas NV 89121-7394 Ph: (725) 305-1192 | 2480 E Tompkins Ave Ste 201 Las Vegas NV 89121-7394 Ph: (725) 305-1192 |
| NPI Number | 1902623713 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902623713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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