Organization
CREATIVE JOURNEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANIA WILFONG LCSW (OWNER)
(702) 527-2873
Entity
Organization
Contact information
Practice address
9414 W LAKE MEAD BLVD, LAS VEGAS, NV 89134-8312
(702) 527-2873
Mailing address
6440 SKY POINTE DR STE 140328, LAS VEGAS, NV 89131-4047
(702) 527-2873
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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