Individual
SHANELL GHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 HELEN AVE, NORTH LAS VEGAS, NV 89030-3721
(702) 636-9229
(702) 636-9229
Mailing address
1200 HELEN AVE, NORTH LAS VEGAS, NV 89030-3721
(702) 636-9229
(702) 636-9229
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942554860
—
NV
Enumeration date
01/22/2014
Last updated
01/22/2014
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