Healthcare Provider Details

I. General information

NPI: 1295385169
Provider Name (Legal Business Name): LYNDA MAUREEN SAVAGE MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4170 S DECATUR BLVD STE C1
LAS VEGAS NV
89103-5863
US

IV. Provider business mailing address

100 PARK VISTA DR UNIT 2013
LAS VEGAS NV
89138-3036
US

V. Phone/Fax

Practice location:
  • Phone: 702-659-8827
  • Fax: 702-852-0984
Mailing address:
  • Phone: 702-460-0457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0953
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: