Individual
SAMELLA STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3025 PALLADIO AVE, NORTH LAS VEGAS, NV 89031-7250
(702) 610-0138
Mailing address
3651 STARRY BEACH AVE, LAS VEGAS, NV 89115-1281
(619) 852-4356
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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