| NPI | 1568900504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA M RUSSELL Owner, Kokua, Counselor 702-336-9232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC5788) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-22 |