Organization
PATHWAYS MENTORSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA MILLER PSYM (APPLIED PSYCHOLOGIST)
(725) 251-1377
Entity
Organization
Contact information
Practice address
1350 N TOWN CENTER DR UNIT 1032, LAS VEGAS, NV 89144-0577
(702) 718-7992
Mailing address
720 CLAXTON AVE, N LAS VEGAS, NV 89084-1250
(702) 718-7992
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
343800000X
Secured Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15974566
—
NV
Enumeration date
07/25/2024
Last updated
07/25/2024
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