Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1023442472 |
---|---|
Provider Name | Jacqueline S Mondy |
First Address | Las Vegas, NV 89102-1682 |
Second Address | Las Vegas, NV 89102-1682 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 21/08/2013 |