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General NPI Number Information
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NPI Number | 1831912013
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Entity Type | Organization
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Legal Business Name | AYURVEDA WELLNESS LTD
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 4270 S DECATUR BLVD STE B6
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City | LAS VEGAS
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State | NV
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Zip | 89103-6802
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Country | US
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Telephone | 702-637-5198
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 S RAINBOW BLVD # 203
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City | LAS VEGAS
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State | NV
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Zip | 89145-6232
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Country | US
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Telephone | 702-637-5198
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERICA L MARINO
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Credential |
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Telephone | 702-637-5198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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