Most Relevant Information
Provider Data
| NPI Number: | 1003386590 |
| Provider Name: | WANDA GASTON |
| Entity Type: | Individual |
| Taxonomy Code: | 251S00000X |
| Specialty: | Community/Behavioral Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/28/2018 |
| Last Updated: | 11/28/2018 |
Provider Practice Location
3925 N. MARTIN LUTHER KING BLVD STE 207
NLV
NV
89032
Practice Location Phone/Fax
| Phone: | 7026847757 |
| Fax: | 7026847381 |
Provider Mailing Location
3925 N. MARTIN LUTHER KING BLVD STE 207
NLV
NV
89032
Provider Mailing Phone/Fax
| Phone: | 7026847757 |
| Fax: | 7026847381 |