Individual
ALTHEA FENNELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 E CHARLESTON BLVD, STE A230, LAS VEGAS, NV 89104-6659
(702) 968-4000
Mailing address
6901 E LAKE MEAD BLVD, APT #1134, LAS VEGAS, NV 89156-1148
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/16/2006
Last updated
07/08/2007
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