Provider Demographics
NPI:1851740906
Name:GEORGIEVA, VANYA (MS)
Entity Type:Individual
Prefix:MRS
First Name:VANYA
Middle Name:
Last Name:GEORGIEVA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:VANYA
Other - Middle Name:TODOROVA
Other - Last Name:GEORGIEVA-MATEV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:2801 S VALLEY VIEW BLVD, STE 6
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-922-7015
Mailing Address - Fax:
Practice Address - Street 1:2801 S VALLEY VIEW BLVD, STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-922-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist