Basic Information
| Provider Information | |||||||||
| NPI: | 1720217516 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAY-SMITH | ||||||||
| FirstName: | NELDA | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 15042 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891145042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023538574 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2801 S VALLEY VW | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891020116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029227015 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2009 | ||||||||
| LastUpdateDate: | 09/30/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | STUDENT | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.