Battle-Born Psychological Services, LLC
Psychologist, Clinical in North Las Vegas, NV. Organization (NPI-2).
NPI number1912377482
StatusActive
Last updated in NPPESApr 13, 2022
Details
- NPI
- 1912377482
- Entity type
- Organization (NPI-2)
- Legal business name
- Battle-Born Psychological Services, LLC
- Organization subpart
- No
- Enumeration date
- Sep 28, 2015
- Certification date
- Apr 12, 2022
- Last updated
- Apr 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
Other names
- Black-Belt Psychological Services (Former Legal Business Name)
Practice location
5836 Beluga Bay StNorth Las Vegas, NV 89081-6843
Phone 702-941-0583 · Fax 702-518-0966
Mailing address
5836 Beluga Bay StNorth Las Vegas, NV 89081-6843
Phone 702-941-0583 · Fax 702-518-0966
Authorized official
Earnest Howard-Rudolph Blackshear
Ceo & Primary Consultant
7029410583
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