Provider Demographics
NPI:1710279062
Name:EVELYN D ADELAJA, MFT
Entity Type:Organization
Organization Name:EVELYN D ADELAJA, MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ADELAJA
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:702-375-9458
Mailing Address - Street 1:2235 E FLAMINGO RD
Mailing Address - Street 2:SUITE 109C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5129
Mailing Address - Country:US
Mailing Address - Phone:702-375-9458
Mailing Address - Fax:
Practice Address - Street 1:2235 E FLAMINGO RD
Practice Address - Street 2:SUITE 109C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5129
Practice Address - Country:US
Practice Address - Phone:702-375-9458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMF01094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty