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Individual

KATHLEEN RISDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LADC

Contact information

Practice address
1640 ALTA DR, #4, LAS VEGAS, NV 89106-4163
(702) 474-6450
(702) 474-6463
Mailing address
1640 ALTA DR, #4, LAS VEGAS, NV 89106-4163
(702) 474-6450
(702) 474-6463

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
135-L
NV
1041C0700X
Clinical Social Worker
Primary
00132-C
NV

Other

Enumeration date
05/14/2013
Last updated
05/14/2013
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