Basic Information
| Provider Information | |||||||||
| NPI: | 1215135736 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOURJI-NASSAR | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS-SLP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BOURJI | ||||||||
| OtherFirstName: | AMY | ||||||||
| OtherMiddleName: | E | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MS-SLP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8540 S EASTERN AVE | ||||||||
| Address2: | SUITE 180 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891232834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027338255 | ||||||||
| FaxNumber: | 7027378255 | ||||||||
| Practice Location | |||||||||
| Address1: | 8540 S EASTERN AVE | ||||||||
| Address2: | SUITE 180 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891232834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027338255 | ||||||||
| FaxNumber: | 7027378255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP-1150 | NV | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.