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NPI Code Detail

MEDICARE: VICTORIA ENRIQUEZ

MEDICARE: VICTORIA ENRIQUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMI4037NV

General Provider Information

NPI Number : 1114308889
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA ENRIQUEZ
Provider Business Mailing Address
First Line : 3320 N BUFFALO DR STE 207
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7411
Country : US
Telephone Number : 702-659-4825
Fax Number :
Provider Business Practice Location Address
First Line : 3320 N BUFFALO DR STE 207
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7411
Country : US
Telephone Number : 702-659-4825
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2015
Last Update Date : 03/10/2022

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Directions to “ VICTORIA ENRIQUEZ ” Practice Location

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