Provider Demographics
NPI:1598776247
Name:RAMOS-RIVERA, GLENDA L (LMFT)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:L
Last Name:RAMOS-RIVERA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7341 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1573
Mailing Address - Country:US
Mailing Address - Phone:702-419-8199
Mailing Address - Fax:702-982-6294
Practice Address - Street 1:7341 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1573
Practice Address - Country:US
Practice Address - Phone:702-419-8199
Practice Address - Fax:702-982-6294
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
N/AOtherN/A