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General NPI Number Information
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NPI Number | 1871031658
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Entity Type | Organization
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Legal Business Name | ERICA BIRO, MFT-I
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 7371 W CHARLESTON BLVD STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89117-1575
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Country | US
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Telephone | 702-381-2373
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Fax |
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Provider Business Mailing Address
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Address Line | 2504 MISTLE THRUSH DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-2221
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Country | US
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Telephone | 702-712-2883
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | ERICA BIRO
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Credential | MFT-INTERN
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Telephone | 702-381-2373
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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 | MI0736
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License Number State | NV
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