Individual
MISS LINA LORENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 SHADOW LN STE 120, LAS VEGAS, NV 89102-2342
(702) 382-7746
Mailing address
1120 SHADOW LN STE 120, LAS VEGAS, NV 89102-2342
(702) 595-3968
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9590-M
NV
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124502117
—
NV
Enumeration date
09/17/2018
Last updated
10/21/2021
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