| NPI | 1689142945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN RODRIGUEZ Manager 702-945-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103K00000X Behavior Analyst | |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2019-11-06 |