Individual
MRS. MYRA H AUKUSITINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1 VITA FRESCO CT, HENDERSON, NV 89011-3156
(702) 810-7242
(702) 441-5542
Mailing address
1 VITA FRESCO CT, HENDERSON, NV 89011-3156
(702) 810-7242
(702) 441-5542
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6096S
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110973
BIRTHDATE
MO
Enumeration date
12/08/2011
Last updated
12/08/2011
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