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NPI Code Detail

MEDICARE: MYRNA L TOLEDO MS

MEDICARE:   MYRNA L TOLEDO  MS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1548668262
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRNA L TOLEDO MS
Provider Business Mailing Address
First Line : 7465 W LAKE MEAD BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1033
Country : US
Telephone Number : 702-748-9101
Fax Number :
Provider Business Practice Location Address
First Line : 7465 W LAKE MEAD BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-1033
Country : US
Telephone Number : 702-748-9101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2014
Last Update Date : 03/04/2024

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Directions to “ MYRNA L TOLEDO MS” Practice Location

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