Provider Demographics
NPI:1053691469
Name:MONDESI, NAOMI LOUISE
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:LOUISE
Last Name:MONDESI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 CASA VERDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-5526
Mailing Address - Country:US
Mailing Address - Phone:702-647-6600
Mailing Address - Fax:
Practice Address - Street 1:1923 CASA VERDE DR
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-5526
Practice Address - Country:US
Practice Address - Phone:702-647-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst