Provider Demographics
NPI:1891278982
Name:FERGUSON-MCDOWELL, REJINA
Entity type:Individual
Prefix:
First Name:REJINA
Middle Name:
Last Name:FERGUSON-MCDOWELL
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 1:10245 S MARYLAND PKWY UNIT 283
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4048
Mailing Address - Country:US
Mailing Address - Phone:702-573-4865
Mailing Address - Fax:
Practice Address - Street 1:10245 S MARYLAND PKWY UNIT 283
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-4048
Practice Address - Country:US
Practice Address - Phone:702-981-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NV07007101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst