Organization
XYZ HOLISTIC THERAPY PROF LLC
Active
Other names
XYZ Holistic Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MERCED LCSW (OWNER)
(702) 497-5308
Entity
Organization
Contact information
Practice address
2920 N GREEN VALLEY PKWY STE 314, HENDERSON, NV 89014-0412
(312) 999-8462
Mailing address
2354 BELVEDERE DR, HENDERSON, NV 89014-3657
(702) 497-5308
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558851774
—
NV
Enumeration date
05/17/2021
Last updated
05/17/2021
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