Healthcare Provider Details
I. General information
NPI: 1821722737
Provider Name (Legal Business Name): FACING FORWARD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2022
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
720 W CHEYENNE AVE STE 190
NORTH LAS VEGAS NV
89030-7847
US
IV. Provider business mailing address
4004 LIBERTY MEADOW AVE
NORTH LAS VEGAS NV
89031-0190
US
V. Phone/Fax
- Phone: 702-496-3813
- Fax: 702-459-8264
- Phone: 702-486-3813
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
TAMI
NURKIN
Title or Position: OWNER
Credential: MFT
Phone: 702-496-3813