Provider Demographics
NPI:1053676247
Name:NEYRA, ELIZABETH PANGILINAN
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PANGILINAN
Last Name:NEYRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 E SUNSET RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2745
Mailing Address - Country:US
Mailing Address - Phone:702-782-7689
Mailing Address - Fax:
Practice Address - Street 1:3170 E SUNSET RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2745
Practice Address - Country:US
Practice Address - Phone:702-782-7689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst