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General NPI Number Information
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NPI Number | 1033755764
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Entity Type | Individual
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Provider Name | ASIA JEFFERSON
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Gender | Female
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 720 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89107-3614
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Country | US
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Telephone | 702-331-4874
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Fax |
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Provider Business Mailing Address
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Address Line | 985 WIGWAM PKWY UNIT 1202
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City | HENDERSON
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State | NV
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Zip | 89014-6835
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Country | US
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Telephone | 702-863-9577
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | NV
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