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General NPI Number Information
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NPI Number | 1063619831
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Entity Type | Individual
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Provider Name | LOURDES A. VIADO PHD, MFT
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 6284 S RAINBOW BLVD STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89118
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Country | US
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Telephone | 702-257-0140
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Fax | 702-257-0139
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Provider Business Mailing Address
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Address Line | 2129 TYLER DR
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City | HENDERSON
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State | NV
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Zip | 89074-0630
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Country | US
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Telephone | 702-204-8089
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | RO4347
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License Number State | NV
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