MEDICARE: DR. AARON EVENS BOMER PSY. D, 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
1	1041C0700X	Clinical Social Worker	5642-C	NV

General Provider Information

NPI Number	:	1568646305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON EVENS BOMER PSY. D, LCSW

Provider Business Mailing Address
First Line	:	9078 MASTODON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-1705
Country	:	US
Telephone Number	:	702-639-7524
Fax Number	:

Provider Business Practice Location Address
First Line	:	7351 W CHARLESTON BLVD STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117
Country	:	US
Telephone Number	:	702-639-7524
Fax Number	:

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

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	06/21/2018

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