Individual
VITA MOSS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 S VALLEY VIEW BLVD, STE 6, LAS VEGAS, NV 89102-0116
(702) 505-3635
Mailing address
10120 W FLAMINGO RD, 4-198, LAS VEGAS, NV 89147-8392
(702) 292-1356
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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