Provider Demographics
NPI:1992040679
Name:BOHANA, CLAUDIAN MARY
Entity Type:Individual
Prefix:
First Name:CLAUDIAN
Middle Name:MARY
Last Name:BOHANA
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 1:205 VALLEJO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-4451
Mailing Address - Country:US
Mailing Address - Phone:702-415-9314
Mailing Address - Fax:
Practice Address - Street 1:205 VALLEJO AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110
Practice Address - Country:US
Practice Address - Phone:702-415-9314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health