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NPI Code Detail

MEDICARE: CHRISTAN ANGELINE MAXWELL

MEDICARE:   CHRISTAN ANGELINE MAXWELL
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
1106H00000XMarriage & Family TherapistMI4425NV

General Provider Information

NPI Number : 1427734466
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTAN ANGELINE MAXWELL
Provider Business Mailing Address
First Line : 3830 STADIUM AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-2908
Country : US
Telephone Number : 619-396-0066
Fax Number :
Provider Business Practice Location Address
First Line : 7310 SMOKE RANCH RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0258
Country : US
Telephone Number : 702-608-7290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2023
Last Update Date : 01/14/2025

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Directions to “ CHRISTAN ANGELINE MAXWELL ” Practice Location

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