| NPI | 1801190863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CHUCKALINE O'HARTZ Clinical Social Worker 702-413-6360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 5495-C) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-01-06 |