| NPI | 1649019290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUEZ ERVIN WILSON Owner 775-561-0442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-05-22 |