Provider Demographics
NPI:1376653444
Name:MEYERSON, D (MA)
Entity Type:Individual
Prefix:
First Name:D
Middle Name:
Last Name:MEYERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 PASEO DEL PRADO
Mailing Address - Street 2:SUITE C-109
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4359
Mailing Address - Country:US
Mailing Address - Phone:702-363-3633
Mailing Address - Fax:702-363-5244
Practice Address - Street 1:2330 PASEO DEL PRADO
Practice Address - Street 2:SUITE C-109
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4359
Practice Address - Country:US
Practice Address - Phone:702-363-3633
Practice Address - Fax:702-363-5244
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV217106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist