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NPI Code Detail

MEDICARE: VEX'ALIA WINTER ROSE LCSW

MEDICARE: VEX'ALIA WINTER ROSE LCSW
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
11041C0700XClinical Social Worker7829-CNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PENDINGOTHERNVLICENSE

General Provider Information

NPI Number : 1528436573
Entity Type Code : Individual
Provider Name (Legal Business Name) : VEX'ALIA WINTER ROSE LCSW
Provider Business Mailing Address
First Line : 818 E FLAMINGO RD APT 503
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7335
Country : US
Telephone Number : 702-506-1974
Fax Number :
Provider Business Practice Location Address
First Line : 5426 VEGAS DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-2403
Country : US
Telephone Number : 702-806-5268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2015
Last Update Date : 08/19/2022

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Directions to “ VEX'ALIA WINTER ROSE LCSW” Practice Location

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