Individual
PORSCHA MENYWEATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4316 E TROPICANA AVE, LAS VEGAS, NV 89121-6704
(702) 420-0028
Mailing address
4316 E TROPICANA AVE, LAS VEGAS, NV 89121-6704
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NV20121267098
—
NV
Enumeration date
01/26/2013
Last updated
01/26/2013
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