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General NPI Number Information
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NPI Number | 1710376181
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Entity Type | Organization
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Legal Business Name | FAITH IND AND FAMILY COUNCELING
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 2620 REGATTA DR. SUITE 102
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City | LAS VEGAS
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State | NV
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Zip | 08128
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Country | US
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Telephone | 702-370-4244
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Fax | 702-548-3826
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Provider Business Mailing Address
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Address Line | 2620 REGATTA DR. SUITE 102 SUITE 102
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City | LAS VEGAS
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State | NV
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Zip | 89128
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Country | US
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Telephone | 702-370-4244
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Fax | 702-548-3826
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Authorized Official
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Title or Position | LMFT
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Name | MRS. HEIDI HANUSA
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Credential | LMFT MA
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Telephone | 702-370-4244
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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 |
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License Number State |
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