Healthcare Provider Details

I. General information

NPI: 1558331488
Provider Name (Legal Business Name): PATRICIA L DELGADO MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 E SUNSET RD SUITE 100
LAS VEGAS NV
89120-7202
US

IV. Provider business mailing address

3602 E SUNSET RD SUITE 100
LAS VEGAS NV
89120-7202
US

V. Phone/Fax

Practice location:
  • Phone: 702-932-4308
  • Fax: 702-837-8930
Mailing address:
  • Phone: 702-932-4308
  • Fax: 702-837-8930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0807
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: