Healthcare Provider Details

I. General information

NPI: 1275730251
Provider Name (Legal Business Name): LAWRENCE KAPEL,PH.D. LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 WIGWAM PARKWAY SUITE 100
HENDERSON NV
89074
US

IV. Provider business mailing address

1090 WIGWAM PARKWAY SUITE 100
HENDERSON NV
89074
US

V. Phone/Fax

Practice location:
  • Phone: 702-454-0201
  • Fax: 702-454-1245
Mailing address:
  • Phone: 702-454-0201
  • Fax: 702-454-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY257
License Number StateNV

VIII. Authorized Official

Name: MS. DEBRA ELLEN QUINN
Title or Position: BILLING MANAGER
Credential:
Phone: 702-454-0201