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Individual

MRS. DEJA RACHELLE ETHEL FUIMAONO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
570 W CHEYENNE AVE STE 190, NORTH LAS VEGAS, NV 89030-3983
(702) 350-1898
Mailing address
8321 BELLO CIRCONDA AVE, LAS VEGAS, NV 89178-8257
(702) 350-1898

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8661-C
NV
253J00000X
Foster Care Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
14927028682
NV
05
1497028682
NV
Enumeration date
02/17/2012
Last updated
03/06/2025
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