Mrs. Marysol Rezanov
Clinical Social Worker
4170 S Decatur Blvd Ste C1
Las Vegas
, Nevada 89103-5863
Mrs. Marysol Rezanov
Clinical Social Worker
4170 S Decatur Blvd Ste C1
Las Vegas
, Nevada 89103-5863
(702) 852-0984
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About
Features
Specialties
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Mrs. Marysol Rezanov
- 4170 S Decatur Blvd Ste C1
- Las Vegas, NV
- Zip : 89103-5863
- Fax : (702) 852-0984
- Phone : (702) 659-8827
Second Address
- Mrs. Marysol Rezanov
- 4170 S Decatur Blvd Ste C1
- Las Vegas, NV
- Zip : 89103-5863
- Fax : (702) 852-0984
- Phone : (702) 659-8827
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Is Mrs. Marysol Rezanov a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1041C0700X | Clinical Social Worker | 6215-C | NV |
National Provider Identifier
| NPI | 1003127499 |
|---|---|
| Provider Name | Mrs. Marysol Rezanov |
| First Address | Las Vegas, NV 89103-5863 |
| Second Address | Las Vegas, NV 89103-5863 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2010 |
| Last Update Date | 16/10/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1598015240 | GROUP NPI (01) | NV |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.