Provider Demographics
NPI:1205328853
Name:ARGUELLO, PRISCILLA ALEJANDRA
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:ALEJANDRA
Last Name:ARGUELLO
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 1:1640 ALTA DR STE 4
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4165
Mailing Address - Country:US
Mailing Address - Phone:818-523-5357
Mailing Address - Fax:
Practice Address - Street 1:1640 ALTA DR STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4165
Practice Address - Country:US
Practice Address - Phone:818-523-5357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06752-L101YA0400X
NV4099106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)