NPI 1326474289 · live from the CMS NPI Registry
Fantanesh Angaw
Social Worker, Clinical in Las Vegas, NV. National Provider Identifier 1326474289, active.
NPI record
| NPI | 1326474289 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 7368 N Decatur Blvd, Unit 3, Las Vegas, NV 89131 |
| Practice phone | 702-251-8000 |
| Mailing address | 550 Elm Dr Apt 110, Las Vegas, NV 89169 |
| Enumerated | September 23, 2013 |
| Last updated | May 9, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Social Worker, Clinical primary | 1041C0700X | 8644-C (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.