Provider Demographics
NPI:1023699253
Name:LAMAUTE, SHANDRA E (MFA MSC, MA,)
Entity type:Individual
Prefix:
First Name:SHANDRA
Middle Name:E
Last Name:LAMAUTE
Suffix:
Gender:F
Credentials:MFA MSC, MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7376
Mailing Address - Country:US
Mailing Address - Phone:702-565-1020
Mailing Address - Fax:702-565-1035
Practice Address - Street 1:1640 ARVILLE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-3840
Practice Address - Country:US
Practice Address - Phone:725-212-7444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist