| NPI | 1104167584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD MARTINEZ Youth Counselor 702-360-4669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NV B20-00667-J-112759) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |