Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | NV | |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1174008908 |
---|---|
Provider Name | Courtney M Pataray |
First Address | Las Vegas, NV 89131-4688 |
Second Address | Las Vegas, NV 89130-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2018 |
Last Update Date | 01/07/2021 |