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NPI Code Detail

MEDICARE: AMARA LAURITZEN CGC

MEDICARE: AMARA LAURITZEN CGC
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
1170300000XGenetic Counselor (M.S.)

General Provider Information

NPI Number : 1205373479
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMARA LAURITZEN CGC
Provider Business Mailing Address
First Line : 2011 PINTO LN
Second Line : SUITE 200
City : LAS VEGAS
State : NV
Zip : 89106-4004
Country : US
Telephone Number : 702-382-3200
Fax Number : 702-382-3575
Provider Business Practice Location Address
First Line : 2011 PINTO LN
Second Line : SUITE 200
City : LAS VEGAS
State : NV
Zip : 89106-4004
Country : US
Telephone Number : 702-382-3200
Fax Number : 702-382-3575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2017
Last Update Date : 01/26/2017

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Directions to “ AMARA LAURITZEN CGC” Practice Location

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