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Individual

MISS YESENIA AVALOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LADC, CPGC

Contact information

Practice address
730 N EASTERN AVE, SUITE 130, LAS VEGAS, NV 89101-2883
(702) 598-2020
(702) 598-2018
Mailing address
730 N EASTERN AVE, SUITE 130, LAS VEGAS, NV 89101-2883
(702) 598-2020
(702) 598-2018

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
00130
NV
251S00000X
Community/Behavioral Health Agency
01245
NV

Other

Enumeration date
12/20/2011
Last updated
12/20/2011
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