MEDICARE: MISS GLADYS MORALES

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	:	1831477801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS GLADYS MORALES

Provider Business Mailing Address
First Line	:	2508 MOUNTAIN RAIL DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-3130
Country	:	US
Telephone Number	:	702-834-8954
Fax Number	:

Provider Business Practice Location Address
First Line	:	4431 S EASTERN AVE
Second Line	:	STE 1
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-7850
Country	:	US
Telephone Number	:	702-750-0377
Fax Number	:	702-538-7928

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

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	12/09/2013

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Directions to “ MISS GLADYS MORALES ” Practice Location

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