Individual
JEREMY BISSRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1930 VILLAGE CENTER CIR # 3-2294, LAS VEGAS, NV 89134-6299
(775) 583-7621
Mailing address
1930 VILLAGE CENTER CIR # 3-2294, LAS VEGAS, NV 89134-6299
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
12/08/2022
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