Provider Demographics
NPI:1295900058
Name:SOTTO, FEDELITA (LSW)
Entity type:Individual
Prefix:MISS
First Name:FEDELITA
Middle Name:
Last Name:SOTTO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 RIVER GLEN DR
Mailing Address - Street 2:APT #36
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-8729
Mailing Address - Country:US
Mailing Address - Phone:702-343-9452
Mailing Address - Fax:702-395-6457
Practice Address - Street 1:2965 S JONES BLVD
Practice Address - Street 2:E1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5629
Practice Address - Country:US
Practice Address - Phone:702-733-8098
Practice Address - Fax:702-395-6457
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4916-S101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health