Individual
MARIO WOLTHERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2575 MONTESSOURI ST STE 200, LAS VEGAS, NV 89117-3060
(702) 587-8106
Mailing address
2575 MONTESSOURI ST STE 200, LAS VEGAS, NV 89117-3060
(702) 587-8106
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1403177618
DRIVERS LICENSE
NV
Enumeration date
07/18/2017
Last updated
07/21/2022
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