Organization
AUTISM DIAGNOSTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE WALLISCH M.S.,CCC-SLP (SPEECH LANGUAGE PATHOLOGIST/ CEO)
(702) 213-2123
Entity
Organization
Contact information
Practice address
1775 VILLAGE CENTER CIR STE 190, LAS VEGAS, NV 89134-0571
(702) 213-2123
Mailing address
30 N GOULD ST STE R, SHERIDAN, WY 82801-6317
(702) 213-2123
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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