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General NPI Number Information
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NPI Number | 1417141417
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Entity Type | Individual
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Provider Name | ANNETTE SOBER LADC
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Gender | Female
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Dates
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Enumeration Date | 09/01/2007
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 5575 SIMMONS ST SUITE 1 # 486
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-9009
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Country | US
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Telephone | 702-217-3743
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Fax |
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Provider Business Mailing Address
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Address Line | 5575 SIMMONS ST SUITE 1 # 486
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-9009
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Country | US
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Telephone | 702-217-3743
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5611
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 01504
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0284-S
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License Number State | NV
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