Provider Demographics
NPI:1306186150
Name:DAHAN, MICHELLE (MFT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:DAHAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7371 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE #130
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1575
Mailing Address - Country:US
Mailing Address - Phone:702-856-6763
Mailing Address - Fax:702-685-0549
Practice Address - Street 1:7371 W CHARLESTON BLVD
Practice Address - Street 2:SUITE #130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1575
Practice Address - Country:US
Practice Address - Phone:702-856-6763
Practice Address - Fax:702-685-0549
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01297106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1306186150Medicaid