| NPI | 1114295938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE KONOLD Executive Director 702-630-5644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |