Provider Demographics
NPI:1356580104
Name:ADELAJA, EVELYN DENISE (MFT)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:DENISE
Last Name:ADELAJA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 MANZANARES DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2345
Mailing Address - Country:US
Mailing Address - Phone:702-375-9458
Mailing Address - Fax:
Practice Address - Street 1:2235 E FLAMINGO RD STE 109D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0800
Practice Address - Country:US
Practice Address - Phone:702-375-9458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMF01094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist