Provider Demographics
NPI:1629525647
Name:ORMOND, KATRECA
Entity Type:Individual
Prefix:
First Name:KATRECA
Middle Name:
Last Name:ORMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATRECA
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1516 E TROPICANA AVE STE 146
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-8316
Mailing Address - Country:US
Mailing Address - Phone:702-765-5000
Mailing Address - Fax:702-765-5003
Practice Address - Street 1:1516 E TROPICANA AVE STE 146
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-8316
Practice Address - Country:US
Practice Address - Phone:702-765-5000
Practice Address - Fax:702-765-5003
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20151665818103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst