MEDICARE: ANGEL LASH M.S, CADC-I, CPC-I

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	225400000X	Rehabilitation Practitioner
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1487098273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL LASH M.S, CADC-I, CPC-I

Provider Business Mailing Address
First Line	:	7455 ARROYO CROSSING PKWY
Second Line	:	SUITE 220
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-4085
Country	:	US
Telephone Number	:	702-761-6468
Fax Number	:	702-761-6401

Provider Business Practice Location Address
First Line	:	8101 W FLAMINGO RD
Second Line	:	#2072
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7408
Country	:	US
Telephone Number	:	702-595-2765
Fax Number	:

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

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	03/10/2015

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