Healthcare Provider Details

I. General information

NPI: 1457925224
Provider Name (Legal Business Name): ELEMENTS OF MOTIVATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7040 LAREDO ST STE K
LAS VEGAS NV
89117-3044
US

IV. Provider business mailing address

7040 LAREDO ST STE K
LAS VEGAS NV
89117-3044
US

V. Phone/Fax

Practice location:
  • Phone: 702-331-4874
  • Fax: 702-446-8034
Mailing address:
  • Phone: 702-331-4874
  • Fax: 702-446-8034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: DIANA MARIE SAUNDERS
Title or Position: OWNER
Credential: LMFT
Phone: 702-331-4874