Provider Demographics
NPI:1689035966
Name:TORRES-BELLO, ELISLAIDYS
Entity Type:Individual
Prefix:
First Name:ELISLAIDYS
Middle Name:
Last Name:TORRES-BELLO
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 1:4275 KEVIN WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-3622
Mailing Address - Country:US
Mailing Address - Phone:702-330-6158
Mailing Address - Fax:
Practice Address - Street 1:2304 BRISTOL BAY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2930
Practice Address - Country:US
Practice Address - Phone:702-330-6158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health