Individual
MR. CAMMERON ELIJAH JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QBA
Contact information
Practice address
1516 E TROPICANA AVE STE 280, LAS VEGAS, NV 89119-8343
(702) 586-9674
Mailing address
3770 FAMIGLIA DR, LAS VEGAS, NV 89141-3454
(702) 351-6572
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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