Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1023648813 |
---|---|
Provider Name | Daisy Arias |
First Address | Henderson, NV 89012-5661 |
Second Address | Las Vegas, NV 89104-3916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2020 |
Last Update Date | 21/01/2020 |