MEDICARE: TAMARA JOY IRONS L.C.S.W.

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	1041C0700X	Clinical Social Worker	SW 6231	FL
2	1041C0700X	Clinical Social Worker	4959-C	NV

General Provider Information

NPI Number	:	1467617530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA JOY IRONS L.C.S.W.

Provider Business Mailing Address
First Line	:	8414 FARM RD STE 180
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-8171
Country	:	US
Telephone Number	:	702-695-0757
Fax Number	:

Provider Business Practice Location Address
First Line	:	5420 W SAHARA AVE STE 102-6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0394
Country	:	US
Telephone Number	:	702-907-6043
Fax Number	:

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

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	02/24/2020

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