Individual
INEZ NMN STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7381 PRAIRIE FALCON RD, LAS VEGAS, NV 89128-0811
(702) 468-1321
(702) 243-3757
Mailing address
7381 PRAIRIE FALCON ROAD, SUITE 120, LAS VEGAS, NV 89128
(702) 468-1321
(702) 243-3757
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
00100-L
NV
101Y00000X
Counselor
00102-IG
NV
101YM0800X
Mental Health Counselor
00265-S
NV
101YM0800X
Mental Health Counselor
Primary
MI0156
NV
172V00000X
Community Health Worker
131AL-5
NV
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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