Individual
MRS. KEYONNA FORESTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5005 LOSEE RD APT 3129, NORTH LAS VEGAS, NV 89081-2487
(702) 612-0859
Mailing address
5005 LOSEE RD APT 3129, NORTH LAS VEGAS, NV 89081-2487
(702) 612-0859
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NV
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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