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General NPI Number Information
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NPI Number | 1518202688
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Entity Type | Organization
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Legal Business Name | ABET COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 11/30/2012
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Last Update Date | 11/30/2012
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Provider Practice Location Address
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Address Line | 6531 PLUM ORCHARD CIR
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City | LAS VEGAS
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State | NV
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Zip | 89142-0966
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Country | US
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Telephone | 702-785-2019
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Fax |
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Provider Business Mailing Address
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Address Line | 6531 PLUM ORCHARD CIR
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City | LAS VEGAS
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State | NV
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Zip | 89142-0966
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Country | US
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Telephone | 702-785-2019
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | SANDAL KELLY
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Credential | PHD, LMFT
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Telephone | 702-785-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 01002
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License Number State | NV
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