Provider Demographics
NPI:1073852596
Name:AMEJKO, RAYMOND M
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:M
Last Name:AMEJKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 HARRIS ST APT 423
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6166
Mailing Address - Country:US
Mailing Address - Phone:702-762-2803
Mailing Address - Fax:
Practice Address - Street 1:5421 E HARMON AVE
Practice Address - Street 2:C-19
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-6058
Practice Address - Country:US
Practice Address - Phone:702-595-8392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor