Individual
ALAYAH SHANECE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4850 W FLAMINGO RD, LAS VEGAS, NV 89103-3705
(702) 871-9917
Mailing address
3655 E SAHARA AVE APT NO, LAS VEGAS, NV 89104-4953
(702) 241-3853
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2104925457
NEVADA
NV
01
—
2104925457
NEVADA
—
Enumeration date
03/15/2019
Last updated
03/15/2019
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