Provider Demographics
NPI:1861940538
Name:RANSON, DYNASTY
Entity type:Individual
Prefix:
First Name:DYNASTY
Middle Name:
Last Name:RANSON
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 1:5230 E CRAIG RD APT 203
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-2257
Mailing Address - Country:US
Mailing Address - Phone:702-717-2550
Mailing Address - Fax:
Practice Address - Street 1:1404 N SANDHILL RD
Practice Address - Street 2:APT 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-1129
Practice Address - Country:US
Practice Address - Phone:702-771-6940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV172V00000X
225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No172V00000XOther Service ProvidersCommunity Health Worker