Healthcare Provider Details

I. General information

NPI: 1528718038
Provider Name (Legal Business Name): RACHEL MARIE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3247 S MARYLAND PKWY
LAS VEGAS NV
89109-2412
US

IV. Provider business mailing address

9012 IRON HITCH AVE
LAS VEGAS NV
89143-4438
US

V. Phone/Fax

Practice location:
  • Phone: 702-776-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number822615
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: