Provider Demographics
NPI:1912269176
Name:HOLLINS MOSOKO, RONA YVETTE
Entity Type:Individual
Prefix:MRS
First Name:RONA
Middle Name:YVETTE
Last Name:HOLLINS MOSOKO
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 1:5001 SUPER SONIC AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-2488
Mailing Address - Country:US
Mailing Address - Phone:702-273-4703
Mailing Address - Fax:
Practice Address - Street 1:2608 WHITE OAK RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5341
Practice Address - Country:US
Practice Address - Phone:702-351-0791
Practice Address - Fax:702-921-0111
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health