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General NPI Number Information
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NPI Number | 1700338084
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Entity Type | Organization
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Legal Business Name | ANSARINIA NEURO-HEALTH
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 2835 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89146-5307
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Country | US
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Telephone | 702-951-2243
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Fax |
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Provider Business Mailing Address
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Address Line | 2835 S JONES BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89146-5307
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MEHDI ANSARINIA
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Credential |
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Telephone | 702-951-2243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | NV20161411462
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License Number State | NV
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