Individual
MR. RUSTY LEE PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CCC/SLP
Contact information
Practice address
2785 S RAINBOW BLVD STE 130, LAS VEGAS, NV 89146-4010
(702) 685-6004
Mailing address
9958 KEIFER VALLEY ST, LAS VEGAS, NV 89178-4823
(702) 302-6996
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2222
ND
235Z00000X
Speech-Language Pathologist
SP-730
NV
Other
Enumeration date
02/24/2022
Last updated
09/20/2022
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