Basic Information
| Provider Information | |||||||||
| NPI: | 1487968038 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGINLEY | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | FREDA | ||||||||
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| Credential: | MFT INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3670 N RANCHO DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891303192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028694300 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3670 N RANCHO DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891303192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028694300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2010 | ||||||||
| LastUpdateDate: | 08/05/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MI0199 | NV | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.