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Individual

ILER JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
640 MCKNIGHT STREET, LAS VEGAS, NV 89101
(702) 387-1700
(702) 387-1701
Mailing address
3613 WOODGLEN COURT, LAS VEGAS, NV 89108
(702) 609-2958

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45-3558217
NV
Enumeration date
01/26/2012
Last updated
01/26/2012
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