Most Relevant Information
Provider Data
| NPI Number: | 1003485046 |
| Provider Name: | ANITA STAR ROGHANIAN THORNTON MFT-INTERN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 1003485046 |
Most Important Dates
| Enumeration Date: | 06/23/2021 |
| Last Updated: | 07/10/2023 |
Provider Practice Location
7040 LAREDO ST STE K
LAS VEGAS
NV
891173044
Practice Location Phone/Fax
| Phone: | 7023314874 |
| Fax: |
Provider Mailing Location
3130 S DURANGO DR # 425
LAS VEGAS
NV
891174455
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |