| NPI | 1609118207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUENTA KIRBY Owner 702-682-3586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV NV20131172948) |
| Additional Taxonomies | 103TR0400X Psychologist Rehabilitation (Licence: NV NV20131172948) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-03-21 |