Dianne S Marlon Ltd | |
2975 S Rainbow Blvd Suite J Las Vegas NV 89146-6242 | |
(702) 533-7324 | |
(702) 493-1643 |
Full Name | Dianne S Marlon Ltd |
---|---|
Speciality | Social Worker |
Location | 2975 S Rainbow Blvd, Las Vegas, Nevada |
Authorized Official Name and Position | Dianne S Marlon (OWNER) |
Authorized Official Contact | 7025337324 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dianne S Marlon Ltd 2016 Casa Vista Dr Las Vegas NV 89146-2985 Ph: (702) 533-7324 | Dianne S Marlon Ltd 2975 S Rainbow Blvd Suite J Las Vegas NV 89146-6242 Ph: (702) 533-7324 |
NPI Number | 1790034353 |
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Provider Enumeration Date | 08/29/2012 |
Last Update Date | 09/07/2012 |
Medicare PECOS PAC ID | 2769630201 |
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Medicare Enrollment ID | O20120907000210 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790034353 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6166-C (Nevada) | Primary |
Provider Name | Dianne S Marlon |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649548645 PECOS PAC ID: 2961650361 Enrollment ID: I20120910000325 |
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