Provider Demographics
NPI:1811326093
Name:BIRDOW, VONCHERA AMORI
Entity type:Individual
Prefix:
First Name:VONCHERA
Middle Name:AMORI
Last Name:BIRDOW
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 1:770 WEST LONE MOUTAIN RD.
Mailing Address - Street 2:APT. 2084
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031
Mailing Address - Country:US
Mailing Address - Phone:702-325-9224
Mailing Address - Fax:
Practice Address - Street 1:510 COLLEGE DR
Practice Address - Street 2:1227
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7553
Practice Address - Country:US
Practice Address - Phone:702-325-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health