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NPI Code Detail

MEDICARE: NELANDRA ANSELMO MS, LMFT

MEDICARE: NELANDRA ANSELMO MS, LMFT
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 Therapist01182NV

General Provider Information

NPI Number : 1750522819
Entity Type Code : Individual
Provider Name (Legal Business Name) : NELANDRA ANSELMO MS, LMFT
Provider Business Mailing Address
First Line : 1452 W HORIZON RIDGE PKWY
Second Line : #327
City : HENDERSON
State : NV
Zip : 89012-4422
Country : US
Telephone Number : 702-809-3555
Fax Number : 702-476-2699
Provider Business Practice Location Address
First Line : 2518 ANTHEM VILLAGE DR STE 103
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5554
Country : US
Telephone Number : 702-809-3555
Fax Number : 702-476-2699
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2009
Last Update Date : 02/17/2024

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