| NPI | 1174324008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANCY TOM Nurse 702-606-3445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-03-24 |