Provider Demographics
NPI:1982976544
Name:CLOUD, CHRISTINA L
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:CLOUD
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 1:2445 FIRE MESA ST STE 190
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9015
Mailing Address - Country:US
Mailing Address - Phone:702-212-3008
Mailing Address - Fax:702-933-3064
Practice Address - Street 1:2445 FIRE MESA ST STE 190
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-9015
Practice Address - Country:US
Practice Address - Phone:702-212-3008
Practice Address - Fax:702-933-3064
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-29
Last Update Date:2012-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker