Healthcare Provider Details

I. General information

NPI: 1174805030
Provider Name (Legal Business Name): MS. AMY KATHRYN ANAPOLSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 05/09/2020
Certification Date: 05/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 SAINT ROSE PKWY STE 221
HENDERSON NV
89052-4840
US

IV. Provider business mailing address

1740 HILL CANYON LN
LAS VEGAS NV
89144-5421
US

V. Phone/Fax

Practice location:
  • Phone: 702-589-4871
  • Fax:
Mailing address:
  • Phone: 702-494-9124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8347-C
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: