Provider Demographics
NPI:1154589943
Name:CISNEROS, SILVIA
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:CISNEROS
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 1:5615 S PECOS RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-1961
Mailing Address - Country:US
Mailing Address - Phone:702-736-8100
Mailing Address - Fax:702-736-7881
Practice Address - Street 1:5615 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-1961
Practice Address - Country:US
Practice Address - Phone:702-736-8100
Practice Address - Fax:702-736-7881
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool