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Individual

ILIMA SAM FONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4425 S JONES BLVD, SUITE D-3, LAS VEGAS, NV 89103-3370
(702) 991-3150
(702) 227-3915
Mailing address
4425 S JONES BLVD, SUITE D-3, LAS VEGAS, NV 89103-3370
(702) 991-3150
(702) 227-3915

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
03/12/2017
Last updated
03/12/2017
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