Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 180.010667 | IL |
Y | 101YP2500X | Professional Counselor | CP0210 | NV |
NPI | 1003337635 |
---|---|
Provider Name | Lanecha Williams |
First Address | Las Vegas, NV 89128-6039 |
Second Address | Las Vegas, NV 89128-0297 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2017 |
Last Update Date | 10/07/2017 |