Healthcare Provider Details

I. General information

NPI: 1710252275
Provider Name (Legal Business Name): DOMIANO-SADER THERAPY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2012
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9550 S EASTERN AVE SUITE 220
LAS VEGAS NV
89123-8038
US

IV. Provider business mailing address

9550 S EASTERN AVE SUITE 220
LAS VEGAS NV
89123-8038
US

V. Phone/Fax

Practice location:
  • Phone: 702-292-8711
  • Fax: 702-451-9157
Mailing address:
  • Phone: 702-945-1600
  • Fax: 702-451-9157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NANCY DOMIANO-SADER
Title or Position: MANAGING PARTNER
Credential: LCSW, LADC
Phone: 702-945-1600