Basic Information
| Provider Information | |||||||||
| NPI: | 1972878312 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REYES | ||||||||
| FirstName: | CATHRYN CORNELIA | ||||||||
| MiddleName: | COLLINS | ||||||||
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| Credential: | BSHS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2111 WESTWIND RD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891463333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022455154 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2810 W CHARLESTON BLVD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891021921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028221556 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2012 | ||||||||
| LastUpdateDate: | 07/09/2014 | ||||||||
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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 | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor |
No ID Information.