Healthcare Provider Details

I. General information

NPI: 1609302751
Provider Name (Legal Business Name): KENDRA MEZA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7318 W POST RD STE 211
LAS VEGAS NV
89113-6646
US

IV. Provider business mailing address

9350 WILD LARIAT AVE
LAS VEGAS NV
89178-5522
US

V. Phone/Fax

Practice location:
  • Phone: 702-608-6618
  • Fax:
Mailing address:
  • Phone: 702-608-6618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4523
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: