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4955 S Durango Dr Ste 158 Las Vegas NV 89113-0154 | |
| (702) 234-9325 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4955 S Durango Dr Ste 158, Las Vegas, Nevada |
| Authorized Official Name and Position | Donna Wilburn (OWNER) |
| Authorized Official Contact | 7022349325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1445 Duet Ct Las Vegas NV 89119-0340 Ph: (702) 263-9325 | 4955 S Durango Dr Ste 158 Las Vegas NV 89113-0154 Ph: (702) 234-9325 |
| NPI Number | 1396270872 |
|---|---|
| Provider Enumeration Date | 04/21/2017 |
| Last Update Date | 04/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396270872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0999 (Nevada) | Primary |
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