Provider Demographics
NPI:1568218204
Name:MEZA, SARAH MAE AGBILAY
Entity type:Individual
Prefix:
First Name:SARAH MAE
Middle Name:AGBILAY
Last Name:MEZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAE
Other - Middle Name:
Other - Last Name:MEZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3145 E WARM SPRINGS RD STE 400
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3140
Mailing Address - Country:US
Mailing Address - Phone:702-919-9515
Mailing Address - Fax:702-944-5498
Practice Address - Street 1:3145 E WARM SPRINGS RD STE 400
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3140
Practice Address - Country:US
Practice Address - Phone:702-919-9515
Practice Address - Fax:702-944-5498
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical