Individual
AMANDA FOFANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6396 MCLEOD DR, 9, LAS VEGAS, NV 89120-4428
(702) 912-0600
(702) 912-0601
Mailing address
6500 VEGAS DR, APT # 2120, LAS VEGAS, NV 89108-7707
(760) 646-0535
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/12/2014
Last updated
08/28/2014
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