Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | 1604937212 | NV |
NPI | 1114333168 |
---|---|
Provider Name | Bijan Jalali |
First Address | Las Vegas, NV 89107-2730 |
Second Address | North Las Vegas, NV 89032-8252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2014 |
Last Update Date | 09/07/2014 |