| NPI | 1033902960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIAN CORTEZ Lead Credentialing Specialist 702-473-9841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2025-07-23 |