Individual
FANTANESH ANGAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7368 N DECATUR BLVD, UNIT 3, LAS VEGAS, NV 89131-3070
(702) 251-8000
Mailing address
550 ELM DR APT 110, LAS VEGAS, NV 89169-3617
(702) 630-3458
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
8644-C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8644-C
LCSW
NV
Enumeration date
09/23/2013
Last updated
05/09/2022
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