Organization
COMMUNITY YOUTH INTERALIA
Active
Parent organization
COMMUNITY YOUTH INTERALIA
Other names
Seao Interalia
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY YOUTH INTERALIA
Authorized official
JUDE NIBA ED.D CMPC-AASP (PRESIDENT)
(702) 328-0459
Entity
Organization
Contact information
Practice address
9082 VINTAGE WINE AVE, LAS VEGAS, NV 89148-4916
(702) 328-0459
Mailing address
9082 VINTAGE WINE AVE, LAS VEGAS, NV 89148-4916
(702) 328-0459
Taxonomy
Speciality
Code
Description
License number
State
103TE1100X
Exercise & Sports Psychologist
Primary
667
NV
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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