| NPI | 1447850144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MCDONAGH Officer 702-483-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 174400000X Specialist | |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |