Healthcare Provider Details

I. General information

NPI: 1487575551
Provider Name (Legal Business Name): EXPRESS YOURSELF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8117 BEAR CLAN CT
LAS VEGAS NV
89131-1455
US

IV. Provider business mailing address

8117 BEAR CLAN CT
LAS VEGAS NV
89131-1455
US

V. Phone/Fax

Practice location:
  • Phone: 702-994-6049
  • Fax:
Mailing address:
  • Phone: 702-994-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. LISA D NELSON
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.ED. SLP-CCC
Phone: 702-994-6049