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Individual

STEPHANIE MICHELLE PANKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
1785 E SAHARA AVE STE 160, LAS VEGAS, NV 89104-3759
(702) 252-8342
Mailing address
1785 E SAHARA AVE STE 160, LAS VEGAS, NV 89104-3759
(702) 252-8342
(702) 252-8342

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1312P-S
NV
104100000X
Social Worker
Primary
9097-S
NV
104100000X
Social Worker
IC-1624
NV

Other

Enumeration date
09/03/2020
Last updated
08/12/2021
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