Provider Demographics
NPI:1932566163
Name:PALLETT, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:PALLETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 E WARM SPRINGS RD STE 136
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3138
Mailing Address - Country:US
Mailing Address - Phone:702-502-1469
Mailing Address - Fax:
Practice Address - Street 1:3175 E WARM SPRINGS RD STE 136
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3138
Practice Address - Country:US
Practice Address - Phone:702-502-1469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1790990349OtherLDS FAMILY SERVICES