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General NPI Number Information
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NPI Number | 1912503079
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Entity Type | Individual
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Provider Name | MAYRA ELIZABETH SANTOS
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Gender | Female
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 6655 W SAHARA AVE STE C203
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City | LAS VEGAS
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State | NV
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Zip | 89146-0850
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Country | US
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Telephone | 702-900-2784
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Fax |
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Provider Business Mailing Address
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Address Line | 981 WHITNEY RANCH DR APT 1425
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City | HENDERSON
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State | NV
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Zip | 89014-2573
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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 |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CP5758
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License Number State | NV
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