Individual
MYRA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, PSYD
Contact information
Practice address
2920 S JONES BLVD STE 110B, LAS VEGAS, NV 89146
(702) 443-1373
(702) 960-7229
Mailing address
PO BOX 400755, LAS VEGAS, NV 89140-0755
(702) 444-1373
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0739
NV
1041C0700X
Clinical Social Worker
27278
CA
1041C0700X
Clinical Social Worker
6578-C
NV
Other
Enumeration date
08/07/2010
Last updated
08/22/2018
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