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Individual

EDITH H KLINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
QMHA

Contact information

Practice address
5715 W ALEXANDER RD, SUITE 155, LAS VEGAS, NV 89130-2800
(702) 586-8693
(702) 476-2690
Mailing address
6616 GAZELLE DR, LAS VEGAS, NV 89108-2722
(702) 586-8693
(702) 476-2690

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
777-L
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
687695
687695
NV
Enumeration date
10/15/2011
Last updated
10/15/2011
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