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General NPI Number Information
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NPI Number | 1851648430
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Entity Type | Individual
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Provider Name | MIYISHA HOLLIS MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 801 S RANCHO DR STE C3
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City | LAS VEGAS
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State | NV
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Zip | 89106-3858
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Country | US
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Telephone | 702-385-2153
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Fax |
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Provider Business Mailing Address
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Address Line | 8444 ORCHARD RIDGE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89129-6823
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Country | US
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Telephone | 702-506-2661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 01170-I
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4238
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License Number State | NV
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