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General NPI Number Information
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NPI Number | 1245540673
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Entity Type | Individual
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Provider Name | KRISTINA MOORE-SWIFT
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Gender | Female
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 6767 W TROPICANA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89103-4754
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Country | US
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Telephone | 702-290-0370
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Fax |
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Provider Business Mailing Address
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Address Line | 1014 BRILLIANT MEADOW AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-1533
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Country | US
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Telephone | 702-672-6657
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CI0385
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License Number State | NV
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