Provider Demographics
NPI:1730655614
Name:AYI-BAMAH, NANCY VANETTE
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:VANETTE
Last Name:AYI-BAMAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 N LAMB BLVD APT 138
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-3543
Mailing Address - Country:US
Mailing Address - Phone:310-621-6716
Mailing Address - Fax:
Practice Address - Street 1:2725 E DESERT INN RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3612
Practice Address - Country:US
Practice Address - Phone:775-357-2623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health