Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 01046 | NV |
NPI | 1003253550 |
---|---|
Provider Name | Amanda Nicole Vieira |
First Address | Las Vegas, NV 89130 |
Second Address | North Las Vegas, NV 89030-5642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 18/10/2018 |