Provider Information for 1750034534
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HILARY MODY LCSW
Sex: Female
NPI: 1750034534
Last Updated: 2022-02-01
Certification Date: 2022-02-01
Certification Date: 2022-02-01
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1750034534 | ||||||||
| Enumeration Date | 2022-02-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6350 TARA AVE LAS VEGAS, NV 89146-5241 United States Phone: 917-547-9940 | Fax: | ||||||||
| Primary Practice Address | 6350 TARA AVE LAS VEGAS, NV 89146-5241 United States Phone: 917-547-9940 | Fax: | ||||||||
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