| NPI | 1538712351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK WISE Owner 702-509-1096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2024-07-26 |