Individual
NANNINA LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2255 RENAISSANCE DR STE A, LAS VEGAS, NV 89119-6194
(702) 451-7542
Mailing address
2255 RENAISSANCE DR, LAS VEGAS, NV 89119-6193
(702) 451-7542
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
IC-1324
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IC-1324
LSW LICENSE
NV
Enumeration date
10/26/2018
Last updated
06/11/2019
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