Individual
OTIS WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3719 RUSSIAN OLIVE, NORTH LAS VEGAS, NV 89032-7686
(702) 541-2520
Mailing address
3719 RUSSIAN OLIVE ST, NORTH LAS VEGAS, NV 89032-7649
(702) 540-1252
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0004496940
NV
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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