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General NPI Number Information
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NPI Number | 1710279062
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Entity Type | Organization
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Legal Business Name | EVELYN D ADELAJA, MFT
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 2235 E FLAMINGO RD SUITE 109C
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City | LAS VEGAS
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State | NV
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Zip | 89119-5129
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Country | US
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Telephone | 702-375-9458
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Fax |
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Provider Business Mailing Address
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Address Line | 2235 E FLAMINGO RD SUITE 109C
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City | LAS VEGAS
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State | NV
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Zip | 89119-5129
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Country | US
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Telephone | 702-375-9458
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | EVELYN DENISE ADELAJA
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Credential | MFT
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Telephone | 702-375-9458
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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 | MF01094
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License Number State | NV
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