| NPI | 1609687656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARIE MALLORY Practice Owner 702-608-6495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2025-01-17 |