Provider Demographics
NPI:1699392050
Name:ANYANWU, MUNACHIMSO G
Entity Type:Individual
Prefix:
First Name:MUNACHIMSO
Middle Name:G
Last Name:ANYANWU
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 1:708 CADES COVE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1306
Mailing Address - Country:US
Mailing Address - Phone:229-669-2681
Mailing Address - Fax:
Practice Address - Street 1:708 CADES COVE CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1306
Practice Address - Country:US
Practice Address - Phone:229-669-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor