Organization
GOLDEN VICTORY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICKI MAZZONE (CREDENTIALING COORDINATOR)
(702) 703-1950
Entity
Organization
Contact information
Practice address
2870 S MARYLAND PKWY STE 200, LAS VEGAS, NV 89109-1580
(702) 703-1950
Mailing address
2870 S MARYLAND PKWY STE 200, LAS VEGAS, NV 89109-1580
(702) 703-1950
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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