Individual
MS. MARY E BOHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, LADC
Contact information
Practice address
900 E KAREN AVE, LAS VEGAS, NV 89109-1264
(702) 306-3093
Mailing address
PO BOX 43635, LAS VEGAS, NV 89116-1635
(702) 306-3093
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
569
NV
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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