MEDICARE: NEVADA THERAPY COLLECTIVE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1063345734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA THERAPY COLLECTIVE LLC

Provider Business Mailing Address
First Line	:	5475 YUKON DR
Second Line	:
City	:	SUN VALLEY
State	:	NV
Zip	:	89433-7842
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 MISSION LAGUNA LN APT 203
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2772
Country	:	US
Telephone Number	:	702-530-2554
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	LIZETT MONTES-LOPEZ
Credential	:	CCC-SLP
Telephone Number	:	775-683-0978

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “NEVADA THERAPY COLLECTIVE LLC ” Practice Location

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