Provider Demographics
NPI:1922573922
Name:GEORGIEVSKA, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:GEORGIEVSKA
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 1:6250 W ARBY AVE UNIT 119
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-4635
Mailing Address - Country:US
Mailing Address - Phone:702-326-9916
Mailing Address - Fax:
Practice Address - Street 1:2320 PASEO DEL PRADO
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4358
Practice Address - Country:US
Practice Address - Phone:702-431-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation