| NPI | 1407351356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA WADSWORTH Owner 702-485-9917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NV M10548) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |