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General NPI Number Information
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NPI Number | 1396555397
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Entity Type | Individual
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Provider Name | CHRISTIAN CHARLENE EARL
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Gender | Female
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 1607 E WINDMILL LN STE 300
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City | LAS VEGAS
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State | NV
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Zip | 89123-1910
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Country | US
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Telephone | 702-757-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 10697 W CENTENNIAL PKWY APT 2149
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City | LAS VEGAS
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State | NV
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Zip | 89166-1513
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Country | US
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Telephone | 702-355-3553
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NV
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