Healthcare Provider Details

I. General information

NPI: 1336458553
Provider Name (Legal Business Name): PATRICIA LOMAX B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 W CRAIG RD SUITE A
NORTH LAS VEGAS NV
89032-5115
US

IV. Provider business mailing address

3435 W CRAIG RD SUITE A
NORTH LAS VEGAS NV
89032-5115
US

V. Phone/Fax

Practice location:
  • Phone: 702-750-0377
  • Fax: 702-538-7928
Mailing address:
  • Phone: 702-750-0377
  • Fax: 702-538-7928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: