Organization
LIVING WATER PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARJORY FREDERIC APRN, PMHNP-BC (CEO)
(702) 854-6853
Entity
Organization
Contact information
Practice address
5940 S RAINBOW BLVD STE 400, LAS VEGAS, NV 89118-2507
(702) 854-6853
(702) 758-7315
Mailing address
5940 S RAINBOW BLVD, SUITE 400 #783517, LAS VEGAS, NV 89118-2507
(702) 854-6853
(702) 758-7317
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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