MEDICARE: MISS MARTHA SILVA

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1700229697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARTHA SILVA

Provider Business Mailing Address
First Line	:	119 TILBURY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1187
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 PAINTED MIRAGE RD
Second Line	:	320
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4581
Country	:	US
Telephone Number	:	702-882-4865
Fax Number	:

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

Provider Enumeration Date	:	04/10/2013
Last Update Date	:	04/10/2013

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Directions to “ MISS MARTHA SILVA ” Practice Location

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