Healthcare Provider Details

I. General information

NPI: 1457742348
Provider Name (Legal Business Name): BRE AUNA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 03/25/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 S CIMMARON ROAD
LAS VEGAS NV
89145
US

IV. Provider business mailing address

1555 E FLAMINGO RD STE 158
LAS VEGAS NV
89119-9305
US

V. Phone/Fax

Practice location:
  • Phone: 702-830-9740
  • Fax: 702-830-9741
Mailing address:
  • Phone: 702-385-9097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: