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General NPI Number Information
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NPI Number | 1306197926
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Entity Type | Individual
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Provider Name | NIGGI GRANADO
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Gender | Male
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 5615 CAMERON ST SUITE 7
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City | LAS VEGAS
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State | NV
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Zip | 89118-2233
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Country | US
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Telephone | 702-883-0722
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Fax |
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Provider Business Mailing Address
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Address Line | 2606 S DURANGO DR APARTMENT 175
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City | LAS VEGAS
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State | NV
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Zip | 89117-2650
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Country | US
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Telephone | 702-332-4596
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | NV20121155706
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License Number State | NV
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