Healthcare Provider Details

I. General information

NPI: 1538435896
Provider Name (Legal Business Name): YELENA WEINTRAUB L.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 03/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 S JONES BLVD
LAS VEGAS NV
89146-5395
US

IV. Provider business mailing address

4470 MELROSE ABBEY PL
LAS VEGAS NV
89141-4101
US

V. Phone/Fax

Practice location:
  • Phone: 702-806-5268
  • Fax:
Mailing address:
  • Phone: 702-275-8495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6175-S
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: