Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1568809952 |
---|---|
Provider Name | Jini Muhammad |
First Address | North Las Vegas, NV 89032 |
Second Address | Las Vegas, NV 89146-5655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2013 |
Last Update Date | 13/03/2018 |