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NPI Code Detail

MEDICARE: DELORES LYNN BRANCH M.S

MEDICARE: DELORES LYNN BRANCH M.S
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
1106H00000XMarriage & Family TherapistMI1277NV
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1780003319
Entity Type Code : Individual
Provider Name (Legal Business Name) : DELORES LYNN BRANCH M.S
Provider Business Mailing Address
First Line : 8705 TEXAS RANGER AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7201
Country : US
Telephone Number : 702-249-8673
Fax Number :
Provider Business Practice Location Address
First Line : 4485 S BUFFALO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-5006
Country : US
Telephone Number : 702-900-2152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2014
Last Update Date : 05/15/2023

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