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General NPI Number Information
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NPI Number | 1124306790
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Entity Type | Individual
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Provider Name | MARINA IRENE MEZA LMFT, QMHP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 1810 E SAHARA AVE STE 470
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City | LAS VEGAS
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State | NV
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Zip | 89104-3707
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Country | US
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Telephone | 775-984-8456
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Fax |
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Provider Business Mailing Address
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Address Line | 1810 E SAHARA AVE STE 470
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City | LAS VEGAS
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State | NV
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Zip | 89104-3707
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Country | US
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Telephone | 775-984-8456
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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 | 4270
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License Number State | NV
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