Organization
INTEGRATED EDUCATION SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE KONOLD PH.D. (EXECUTIVE DIRECTOR)
(702) 630-5644
Entity
Organization
Contact information
Practice address
4075 N RANCHO DR, LAS VEGAS, NV 89130-3416
(702) 630-5644
Mailing address
PO BOX 94463, LAS VEGAS, NV 89193-4463
(702) 630-5644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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