Individual
ANDREA E MILLSAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9599 W CHARLESTON BLVD APT 1169, LAS VEGAS, NV 89117-6670
(702) 715-7887
Mailing address
9599 W CHARLESTON BLVD STE 1169, LAS VEGAS, NV 89117-6654
(702) 715-7887
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005056211
—
NV
Enumeration date
10/08/2010
Last updated
10/08/2010
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