Provider Demographics
NPI:1700167624
Name:NEAL, MAYA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MAYA
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 S BUFFALO DR STE 107
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2506
Mailing Address - Country:US
Mailing Address - Phone:702-283-1068
Mailing Address - Fax:
Practice Address - Street 1:3230 S BUFFALO DR STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2506
Practice Address - Country:US
Practice Address - Phone:702-283-1068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01246106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist