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General NPI Number Information
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NPI Number | 1689180812
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Entity Type | Individual
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Provider Name | LYNDA MARI
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Gender | Female
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 5450 W SAHARA AVE STE 320
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City | LAS VEGAS
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State | NV
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Zip | 89146-0383
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Country | US
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Telephone | 702-997-4607
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Fax |
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Provider Business Mailing Address
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Address Line | 3150 W SAHARA AVE STE B21
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City | LAS VEGAS
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State | NV
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Zip | 89102-6002
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Country | US
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Telephone | 443-281-3836
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP7328
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CI0330
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License Number State | NV
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