Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0838 | NV |
NPI | 1003022633 |
---|---|
Provider Name | Miss Sheila Acosta Marquez |
First Address | Las Vegas, NV 89135-2064 |
Second Address | Las Vegas, NV 89119-5488 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |