Healthcare Provider Details

I. General information

NPI: 1780100248
Provider Name (Legal Business Name): WARLYN ANTONIO HUFFEY RMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 08/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 W CHARLESTON BLVD STE 150
LAS VEGAS NV
89102-1964
US

IV. Provider business mailing address

9005 W TORINO AVE
LAS VEGAS NV
89148-5127
US

V. Phone/Fax

Practice location:
  • Phone: 702-790-2701
  • Fax: 702-790-2706
Mailing address:
  • Phone: 702-488-2095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: