Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043515489 |
---|---|
Provider Name | Ms. Felicia Amber Taylor |
First Address | Las Vegas, NV 89148-5120 |
Second Address | Las Vegas, NV 89148-5120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2011 |
Last Update Date | 16/01/2011 |