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General NPI Number Information
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NPI Number | 1861320160
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Entity Type | Individual
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Provider Name | JENNIFER TRUITT
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Gender | Female
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 4505 S MARYLAND PARKWAY MAIL STOP 3033
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City | LAS VEGAS
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State | NV
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Zip | 89154-3033
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Country | US
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Telephone | 702-895-1532
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Fax | 702-895-1530
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Provider Business Mailing Address
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Address Line | 4505 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89154-9900
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Country | US
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Telephone | 725-281-0608
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PT098
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License Number State | NV
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