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General NPI Number Information
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NPI Number | 1730499161
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Entity Type | Organization
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Legal Business Name | G ALEX PROFESSIONAL SERVICES, LLC
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 6819 W TROPICANA AVE SUITE 200
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City | LAS VEGAS
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State | NV
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Zip | 89103
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Country | US
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Telephone | 702-807-7349
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Fax | 702-804-6369
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Provider Business Mailing Address
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Address Line | 7121 W. CRAIG ROAD SUITE 113/185
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City | LAS VEGAS
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State | NV
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Zip | 89129
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Country | US
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Telephone | 702-807-7349
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Fax | 702-804-6369
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MISS GLEN ALEX
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Credential | LCSW
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Telephone | 702-807-7349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2973-C
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License Number State | NV
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