MEDICARE: MISS MELENAITE LOLOHEA SANFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	1800561611	NV

General Provider Information

NPI Number	:	1174863567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MELENAITE LOLOHEA SANFT

Provider Business Mailing Address
First Line	:	3077 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3752
Country	:	US
Telephone Number	:	702-998-6264
Fax Number	:	702-998-6270

Provider Business Practice Location Address
First Line	:	3960 E PATRICK LN STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4902
Country	:	US
Telephone Number	:	702-998-6264
Fax Number	:	702-998-6270

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2013
Last Update Date	:	02/21/2013

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