Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 4100023245 | NV |
NPI | 1003116450 |
---|---|
Provider Name | Tascia Avce Branton-Jones |
First Address | Las Vegas, NV 89113-6117 |
Second Address | Las Vegas, NV 89146-1126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2010 |
Last Update Date | 01/11/2010 |