Provider Demographics
NPI:1437567229
Name:SANCHEZ, DESIRAE YVETTE
Entity Type:Individual
Prefix:MS
First Name:DESIRAE
Middle Name:YVETTE
Last Name:SANCHEZ
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 1:4688 TAMALPIAS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-1638
Mailing Address - Country:US
Mailing Address - Phone:702-355-8771
Mailing Address - Fax:
Practice Address - Street 1:6767 W CHARLESTON BLVD
Practice Address - Street 2:STE. 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9073
Practice Address - Country:US
Practice Address - Phone:702-629-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health