Provider Demographics
NPI:1215232566
Name:TUIOTI-MARINER, GEORGE JUNIOR (BA)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:JUNIOR
Last Name:TUIOTI-MARINER
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4274 VIA DANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4238
Mailing Address - Country:US
Mailing Address - Phone:702-771-9147
Mailing Address - Fax:
Practice Address - Street 1:4274 VIA DANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-4238
Practice Address - Country:US
Practice Address - Phone:702-771-9147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor