Individual
ANQUONETTA AVA MCCOLLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2725 S JONES BLVD STE 101, LAS VEGAS, NV 89146-5605
(409) 457-3688
Mailing address
1240 W OWENS AVE STE 1, LAS VEGAS, NV 89106-2452
(702) 410-5295
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
06/27/2024
Last updated
12/11/2024
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