| NPI | 1831912013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA L MARINO Owner 702-637-5198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TH0004X Psychologist Health | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2025-01-21 |