Healthcare Provider Details

I. General information

NPI: 1649224700
Provider Name (Legal Business Name): MARY RAMSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6375 W CHARLESTON BLVD
LAS VEGAS NV
89146-1139
US

IV. Provider business mailing address

6375 W CHARLESTON BLVD
LAS VEGAS NV
89146-1139
US

V. Phone/Fax

Practice location:
  • Phone: 702-253-0818
  • Fax:
Mailing address:
  • Phone: 702-253-0818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4788-S
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: