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General NPI Number Information
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NPI Number | 1194015008
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Entity Type | Individual
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Provider Name | EDITH LIRA
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Gender | Female
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 9550 S. EASTERN AVE. STE.253
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City | LAS VEGAS
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State | NV
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Zip | 89123
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Country | US
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Telephone | 702-523-5400
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Fax | 702-450-4239
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Provider Business Mailing Address
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Address Line | 9550 S. EASTERN AVE. STE.253
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City | LAS VEGAS
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State | NV
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Zip | 89123
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Country | US
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Telephone | 702-523-5400
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Fax | 702-450-4239
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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 | MI0922
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License Number State | NV
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