Individual
DR. JUDE NIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9082 VINTAGE WINE AVE, LAS VEGAS, NV 89148
(170) 232-8045
Mailing address
9082 VINTAGE WINE AVE, LAS VEGAS, NV 89148-4916
(170) 232-8045
Taxonomy
Speciality
Code
Description
License number
State
103TE1100X
Exercise & Sports Psychologist
Primary
667
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
667
ASSOCIATION FOR APPLIED SPORT PSYCHOLOGY
—
Enumeration date
04/27/2018
Last updated
06/16/2018
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