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General NPI Number Information
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NPI Number | 1427734466
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Entity Type | Individual
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Provider Name | CHRISTAN ANGELINE MAXWELL
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 7310 SMOKE RANCH RD
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City | LAS VEGAS
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State | NV
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Zip | 89128-0258
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Country | US
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Telephone | 702-608-7290
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Fax |
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Provider Business Mailing Address
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Address Line | 3830 STADIUM AVE
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City | LAS VEGAS
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State | NV
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Zip | 89120-2908
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Country | US
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Telephone | 619-396-0066
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MI4425
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License Number State | NV
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