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General NPI Number Information
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NPI Number | 1417719022
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Entity Type | Organization
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Legal Business Name | ASD.ME, INC.
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 10845 GRIFFITH PEAK DR STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89135-1568
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Country | US
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Telephone | 646-645-2108
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Fax | 702-904-9746
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Provider Business Mailing Address
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Address Line | 10245 JERSEY SHORE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89135-1153
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Country | US
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Telephone | 646-645-2108
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL E JOHNSON
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Credential |
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Telephone | 888-279-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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