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NPI Code Detail

MEDICARE: JAMIL ALI, PSY.D. LLC

MEDICARE: JAMIL ALI, PSY.D. LLC
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
1103TR0400XRehabilitation PsychologistPSY0366NV

General Provider Information

NPI Number : 1447675483
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMIL ALI, PSY.D. LLC
Provider Business Mailing Address
First Line : 7221 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1580
Country : US
Telephone Number : 702-212-3008
Fax Number : 702-933-3064
Provider Business Practice Location Address
First Line : 7221 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1580
Country : US
Telephone Number : 702-212-3008
Fax Number : 702-933-3064
Authorized Official
Title or Position : OWNER
Name : JAMIL M ALI
Credential : PSY.D.
Telephone Number : 702-212-3008
Provider Enumeration Date : 02/27/2014
Last Update Date : 03/31/2014

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