Individual
SHANNON KEALOHA FUKUSHIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6171 W CHARLESTON BLVD BLDG 10, LAS VEGAS, NV 89146-1126
(725) 289-5889
Mailing address
6171 W CHARLESTON BLVD BLDG 10, LAS VEGAS, NV 89146-1126
(725) 289-5889
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/31/2020
Last updated
08/21/2023
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