| NPI | 1417631706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SUE GUERRA Owner 702-203-7996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |