Healthcare Provider Details

I. General information

NPI: 1114222536
Provider Name (Legal Business Name): CHRISTINA PARISE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3097 E WARM SPRINGS RD STE 400
LAS VEGAS NV
89120-3757
US

IV. Provider business mailing address

5615 S PECOS RD
LAS VEGAS NV
89120-1961
US

V. Phone/Fax

Practice location:
  • Phone: 702-582-6063
  • Fax: 702-825-0093
Mailing address:
  • Phone: 702-736-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8099-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: