Individual
ANTHONY DASTRUP I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6877 W CHARLESTON BLVD, LAS VEGAS, NV 89117-1600
(702) 331-4874
Mailing address
1946 TIDE CT, LAS VEGAS, NV 89156-6963
(702) 682-6287
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/19/2014
Last updated
11/19/2014
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