Organization
MARY JO GILL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY GILL (CLINICAL)
(702) 817-2636
Entity
Organization
Contact information
Practice address
9689 PINE THICKETT AVE, LAS VEGAS, NV 89147-6746
(702) 817-2636
Mailing address
9689 PINE THICKETT AVE, LAS VEGAS, NV 89147-6746
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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