Individual
LESLEY DE LA RIVA LONGORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
850 MILL ST, RENO, NV 89502-1413
(775) 538-6700
Mailing address
1713 CLOUD PEAK DR, SPARKS, NV 89436-8690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MI4012
NV
225C00000X
Rehabilitation Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5307998812
—
NV
Enumeration date
09/07/2016
Last updated
07/20/2021
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