Individual
CHARLENE M PRICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1116 MALIBU SANDS AVE, NORTH LAS VEGAS, NV 89086-1328
(702) 575-5238
(702) 649-6374
Mailing address
1116 MALIBU SANDS AVE, NORTH LAS VEGAS, NV 89086-1328
(702) 575-5238
(702) 649-6374
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005055270
—
NV
Enumeration date
09/28/2010
Last updated
09/28/2010
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