| NPI | 1720509771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE KIRKLAND Manager 702-917-8929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-08-29 |