Provider Information for 1497921605
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Dr. AYELE E AMAVIGAN Ed.D, MSW, LCSW
Sex: Female
NPI: 1497921605
Last Updated: 2022-07-29
Certification Date: 2022-07-20
Certification Date: 2022-07-20
Details
| Name | Value | ||||||||
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| NPI | 1497921605 | ||||||||
| Enumeration Date | 2008-05-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6121 MEADOW VIEW LN LAS VEGAS, NV 89103-1121 United States Phone: 702-806-9143 | Fax: | ||||||||
| Primary Practice Address | 2585 S JONES BLVD STE 2F LAS VEGAS, NV 89146-5604 United States Phone: 702-806-9143 | Fax: | ||||||||
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