Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1063847788 |
---|---|
Provider Name | Rachael Richardson |
First Address | Las Vegas, NV 89104-5460 |
Second Address | Las Vegas, NV 89104-5460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |