Provider Demographics
NPI:1609176114
Name:MEADORS, ANNAH-LIZAH VAQUILAR (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANNAH-LIZAH
Middle Name:VAQUILAR
Last Name:MEADORS
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 1:4356 HERA TEMPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3459
Mailing Address - Country:US
Mailing Address - Phone:702-373-5474
Mailing Address - Fax:
Practice Address - Street 1:4538 W CRAIG RD STE 290
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2511
Practice Address - Country:US
Practice Address - Phone:702-486-5614
Practice Address - Fax:702-486-5630
Is Sole Proprietor?:No
Enumeration Date:2010-10-30
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMFT01145106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist