MEDICARE: PRISCILLA K MUNOZ

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
1	104100000X	Social Worker	11320-M	NV

General Provider Information

NPI Number	:	1114740024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA K MUNOZ

Provider Business Mailing Address
First Line	:	4029 RED PONY CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-3287
Country	:	US
Telephone Number	:	702-501-0359
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 W SUNSET RD STE 102
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-4112
Country	:	US
Telephone Number	:	725-241-5252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	11/07/2024

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Directions to “ PRISCILLA K MUNOZ ” Practice Location

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