Individual
MISS KIASHA SHIREE BAGGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3925 N. MARTIN LUTHER KING BLVD., STE 211, NORTH LAS VEGAS, NV 89032
(702) 488-2284
Mailing address
3925 N. MARTIN LUTHER KING BLVD., STE 211, NORTH LAS VEGAS, NV 89032
(702) 488-2284
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831602291
—
NV
Enumeration date
02/15/2018
Last updated
02/15/2018
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