Individual
MS. KELLY MAE BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3652 N RANCHO DR, STE. 102, LAS VEGAS, NV 89130-3178
(702) 334-6162
(702) 515-0660
Mailing address
3652 N. RANCHO DR., STE. 102, LAS VEGAS, NV 89130
(702) 334-6162
(702) 515-0660
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
01076
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100512262
—
NV
Enumeration date
05/01/2007
Last updated
03/15/2012
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