Individual
MAIMOUNA ROSE CANTRALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1600 E DESERT INN RD STE 104, LAS VEGAS, NV 89169-2505
(702) 208-2194
Mailing address
767 CANYON CREST DR, LAS VEGAS, NV 89123-0533
(702) 589-0701
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
5885-S
NV
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5885-S
—
NV
Enumeration date
11/11/2015
Last updated
03/23/2026
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