Provider Demographics
NPI:1861862047
Name:GUECO, MARIEL
Entity Type:Individual
Prefix:
First Name:MARIEL
Middle Name:
Last Name:GUECO
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 1:2444 ANTLER POINT DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6269
Mailing Address - Country:US
Mailing Address - Phone:702-308-5890
Mailing Address - Fax:
Practice Address - Street 1:2444 ANTLER POINT DR.
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:702-308-5890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2021-08-25
Deactivation Date:2017-01-18
Deactivation Code:
Reactivation Date:2021-08-25
Provider Licenses
StateLicense IDTaxonomies
NV1703061348103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst