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General NPI Number Information
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NPI Number | 1881414365
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Entity Type | Organization
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Legal Business Name | NAKED ATHLETIX FITNESS
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 3053 W CRAIG RD STE E160
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-5124
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Country | US
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Telephone | 702-876-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 3053 W CRAIG RD STE E160
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-5124
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL TEAGUES
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Credential |
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Telephone | 702-876-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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