Healthcare Provider Details

I. General information

NPI: 1639896186
Provider Name (Legal Business Name): ALEXIS MILLIUS-PRETAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 W WARM SPRINGS RD STE 110
HENDERSON NV
89014-7367
US

IV. Provider business mailing address

1489 W WARM SPRINGS RD STE 110
HENDERSON NV
89014-7367
US

V. Phone/Fax

Practice location:
  • Phone: 702-582-6063
  • Fax: 9-370-2825
Mailing address:
  • Phone: 702-582-6063
  • Fax: 9-370-2825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12124-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: