| NPI | 1912310368 |
|---|---|
| Doing Business As | CHRISTINE MICHELLE FORMICA |
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MICHELLE MCANINCH Owner/Therapist 702-673-7462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 6553-C) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2019-06-11 |