| NPI | 1043981467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA POOLE Credentialing 702-848-6004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2021-09-24 |