Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1053674358 |
---|---|
Provider Name | Mrs. Gayle Darleen Wright |
First Address | Las Vegas, NV 89103 |
Second Address | Las Vegas, NV 89103-3307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 21/06/2012 |