Provider Demographics
NPI:1710243662
Name:CORO, EMMA L (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:EMMA
Middle Name:L
Last Name:CORO
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 1:7016 RIO GRANDE GORGE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1012
Mailing Address - Country:US
Mailing Address - Phone:702-353-6046
Mailing Address - Fax:
Practice Address - Street 1:6290 S PECOS RD STE 400
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:702-478-5080
Practice Address - Fax:702-297-6586
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI1189106H00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst