Healthcare Provider Details

I. General information

NPI: 1073723748
Provider Name (Legal Business Name): MARILYN HAMLIN PALASKY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9402 W LAKE MEAD BLVD SUITE 115
LAS VEGAS NV
89134-8312
US

IV. Provider business mailing address

9402 W LAKE MEAD BLVD SUITE 115
LAS VEGAS NV
89134-8312
US

V. Phone/Fax

Practice location:
  • Phone: 702-324-8416
  • Fax: 702-642-5367
Mailing address:
  • Phone: 702-324-8416
  • Fax: 702-642-5367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5121-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: