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Individual

MR. ANTONIO JORGE GILMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.W/L.S.W-PENDING

Contact information

Practice address
4285 N RANCHO DR, STE 130, LAS VEGAS, NV 89130-3446
(702) 385-5331
(702) 385-5678
Mailing address
9101 W SAHARA AVE, STE 105 #190, LAS VEGAS, NV 89117-5772
(702) 266-5636
(702) 869-8870

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
225400000X
Rehabilitation Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104100000X
NV
05
225400000X
NV
Enumeration date
02/01/2011
Last updated
02/01/2011
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