Provider Demographics
NPI:1215135736
Name:BOURJI-NASSAR, AMY E (MS-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:E
Last Name:BOURJI-NASSAR
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:BOURJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS-SLP
Mailing Address - Street 1:8540 S EASTERN AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2834
Mailing Address - Country:US
Mailing Address - Phone:702-733-8255
Mailing Address - Fax:702-737-8255
Practice Address - Street 1:8540 S EASTERN AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2834
Practice Address - Country:US
Practice Address - Phone:702-733-8255
Practice Address - Fax:702-737-8255
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist