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General NPI Number Information
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NPI Number | 1609080688
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Entity Type | Organization
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Legal Business Name | BARRERA PSYCHOLOGICAL SERVICES CENTER
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 701 N GREEN VALLEY PKWY SUITE 200
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City | HENDERSON
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State | NV
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Zip | 89074-6177
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Country | US
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Telephone | 702-952-2894
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Fax |
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Provider Business Mailing Address
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Address Line | 701 N GREEN VALLEY PKWY SUITE 200
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City | HENDERSON
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State | NV
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Zip | 89074-6177
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Country | US
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Telephone | 702-952-2894
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICIA BARRERA
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Credential | PHD
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Telephone | 702-952-2894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY228
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License Number State | NV
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