Healthcare Provider Details

I. General information

NPI: 1992260434
Provider Name (Legal Business Name): SANDRA MARIA BELARDO-RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3344 GROUSE HOUSE LN
NORTH LAS VEGAS NV
89084-2351
US

IV. Provider business mailing address

3344 GROUSE HOUSE LN
NORTH LAS VEGAS NV
89084-2351
US

V. Phone/Fax

Practice location:
  • Phone: 702-468-1570
  • Fax:
Mailing address:
  • Phone: 702-468-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: