Organization
DIAGNOSTICAID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA BROWN (DIRECTOR)
(702) 807-7443
Entity
Organization
Contact information
Practice address
500 N RAINBOW BLVD STE 300, LAS VEGAS, NV 89107-1061
(702) 807-7443
Mailing address
500 N RAINBOW BLVD STE 300, LAS VEGAS, NV 89107-1061
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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