| NPI | 1629593967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE DONOHUE Authorized Official 702-403-0438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2019-09-20 |