Provider Demographics
NPI:1528347002
Name:CELLONA, LOUIE NOVELO
Entity type:Individual
Prefix:
First Name:LOUIE
Middle Name:NOVELO
Last Name:CELLONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 S FORT APACHE RD APT 149
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4690
Mailing Address - Country:US
Mailing Address - Phone:702-467-0284
Mailing Address - Fax:
Practice Address - Street 1:3450 W CHEYENNE AVE STE 500
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8225
Practice Address - Country:US
Practice Address - Phone:702-631-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst