| NPI | 1609684380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ODELAISY AREVALO BLANCO Owner 702-661-6416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2024-12-26 |
| Last Update Date | 2024-12-26 |