Provider Demographics
NPI:1891330809
Name:ULAN, REYMON (CPC)
Entity Type:Individual
Prefix:
First Name:REYMON
Middle Name:
Last Name:ULAN
Suffix:
Gender:M
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2298 W HORIZON RIDGE PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2698
Mailing Address - Country:US
Mailing Address - Phone:702-608-3239
Mailing Address - Fax:702-242-5252
Practice Address - Street 1:2298 W HORIZON RIDGE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2698
Practice Address - Country:US
Practice Address - Phone:702-417-5518
Practice Address - Fax:702-242-5252
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI715101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty