Provider Demographics
NPI:1740614395
Name:GUESS, NICOLE (MPA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:GUESS
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8805 JEFFREYS ST
Mailing Address - Street 2:SUITE 2077
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-4877
Mailing Address - Country:US
Mailing Address - Phone:702-714-1691
Mailing Address - Fax:
Practice Address - Street 1:1485 W WARM SPRINGS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7631
Practice Address - Country:US
Practice Address - Phone:702-714-1691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional