Individual
MS. SHAWNETTE ELAINE ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-I
Contact information
Practice address
6431 W SAHARA AVE STE 200, LAS VEGAS, NV 89146-3064
(702) 258-5855
(702) 258-9767
Mailing address
6431 W SAHARA AVE STE 200, LAS VEGAS, NV 89146-3064
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01166-INTERN
NV
Other
Enumeration date
05/17/2013
Last updated
05/17/2013
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