Provider Demographics
NPI:1568944353
Name:GUIGAYOMA, VIOLET
Entity Type:Individual
Prefix:
First Name:VIOLET
Middle Name:
Last Name:GUIGAYOMA
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 1:3650 N RANCHO DR STE 112
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3151
Mailing Address - Country:US
Mailing Address - Phone:702-476-9394
Mailing Address - Fax:702-665-4720
Practice Address - Street 1:3650 N RANCHO DR STE 112
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3151
Practice Address - Country:US
Practice Address - Phone:702-476-9394
Practice Address - Fax:702-665-4720
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0965101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral