Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1205350006 |
---|---|
Provider Name | Omonigho Edith Usigbe |
First Address | North Las Vegas, NV 89030-4109 |
Second Address | North Las Vegas, NV 89030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2017 |
Last Update Date | 02/08/2017 |