Organization
CENTENNIAL PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PUCCI L.C.S.W. (CLINICAL DIRECTOR)
(702) 278-8911
Entity
Organization
Contact information
Practice address
7495 W AZURE DR, STE 205, LAS VEGAS, NV 89130-4416
(702) 608-0404
Mailing address
7495 W AZURE DR, STE 205, LAS VEGAS, NV 89130-4416
(702) 608-0404
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6050-C
NV
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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