Healthcare Provider Details

I. General information

NPI: 1134260235
Provider Name (Legal Business Name): MS. LUCY SALKOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LUCILLE SALKOFF

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4538 W CRAIG RD SUITE 290
NORTH LAS VEGAS NV
89032-2508
US

IV. Provider business mailing address

HC 33 BOX 3005
LAS VEGAS NV
89124-9251
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-5610
  • Fax:
Mailing address:
  • Phone: 702-217-8974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC2389
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: