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General NPI Number Information
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NPI Number | 1396131322
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Entity Type | Individual
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Provider Name | TONI ELIZABETH-IVY PAULY CPC
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Gender | Female
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 1321 S HWY 160 STE 3E
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City | PAHRUMP
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State | NV
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Zip | 89048-1126
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Country | US
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Telephone | 725-724-5779
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Fax |
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Provider Business Mailing Address
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Address Line | 5601 BLUE PEAK AVE
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City | LAS VEGAS
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State | NV
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Zip | 89131-2512
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Country | US
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Telephone | 725-724-5779
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CP1270
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License Number State |
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