Individual
XSANA PHOUMIPHAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3709 W OAKEY BLVD, LAS VEGAS, NV 89102-3832
(702) 582-3979
Mailing address
3709 W OAKEY BLVD, LAS VEGAS, NV 89102-3832
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CI5057
NV
Other
Enumeration date
12/17/2018
Last updated
02/24/2022
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