Provider Demographics
NPI:1811641772
Name:GARAY, YESENIA
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:GARAY
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 1:4287 EL ANTONIO PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-6619
Mailing Address - Country:US
Mailing Address - Phone:702-265-8130
Mailing Address - Fax:775-372-6126
Practice Address - Street 1:4580 S EASTERN AVE STE 31E
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6100
Practice Address - Country:US
Practice Address - Phone:702-265-8130
Practice Address - Fax:775-372-6126
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor