Individual
MARISSA SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3755 W LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89032-4897
(702) 541-5057
Mailing address
3755 W LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89032-4897
(702) 541-5057
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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