Healthcare Provider Details

I. General information

NPI: 1508572397
Provider Name (Legal Business Name): ASHLEY VRANES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 FIRE MESA ST STE 190
LAS VEGAS NV
89128-9015
US

IV. Provider business mailing address

2445 FIRE MESA ST STE 190
LAS VEGAS NV
89128-9015
US

V. Phone/Fax

Practice location:
  • Phone: 702-456-4262
  • Fax:
Mailing address:
  • Phone: 702-456-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMI4203
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: