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NPI 1558018010 · on the registry since 2022 · sole proprietor

Practice

Address: 801 S Rancho Dr Ste A2
Las Vegas, NV 89106
Phone: (702) 483-3630
Organisation at this address: Pbc Llc
Jgbb Llc
Puso, Llc
Kdtk Corp Llc
Signs Of Hope
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 107

Registry record

Primary taxonomy: 363LA2200X
363LA2200X
Also registered as: 363LG0600X
363LP2300X
Licence states on file: NV
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2022-04-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Nevada