| NPI | 1265078273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ANTHONY EDDINS Chief Administrator 702-489-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TF0000X Psychologist Family | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2024-02-16 |