Individual
MS. ANGELINA FAWN JOHNNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6889 SOUTH EASTERN AVENUE, LAS VEGAS, NV 89119
(702) 434-1200
Mailing address
8367 EMBRY HILLS ST, LAS VEGAS, NV 89113-4602
(725) 260-5108
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
07/02/2014
Last updated
11/17/2022
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