Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1043799216 |
---|---|
Provider Name | Chinazor Thelma Ezeli |
First Address | Henderson, NV 89074-0660 |
Second Address | Las Vegas, NV 89102-4383 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2018 |
Last Update Date | 24/09/2018 |