Provider Demographics
NPI:1699175505
Name:ABOAGYE-KWAKYE, LINDA (MFTI)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ABOAGYE-KWAKYE
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E DESERT INN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2525
Mailing Address - Country:US
Mailing Address - Phone:702-490-9009
Mailing Address - Fax:
Practice Address - Street 1:1600 E DESERT INN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2525
Practice Address - Country:US
Practice Address - Phone:702-490-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health