MEDICARE: LILIA MAHONY

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	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1881020675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIA MAHONY

Provider Business Mailing Address
First Line	:	5135 CAMINO AL NORTE STE 251
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-2419
Country	:	US
Telephone Number	:	702-813-5413
Fax Number	:

Provider Business Practice Location Address
First Line	:	4332 TWIN PEAKS DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0111
Country	:	US
Telephone Number	:	702-813-5413
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	09/24/2013

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Directions to “ LILIA MAHONY ” Practice Location

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