Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033629597 |
---|---|
Provider Name | Ms. Mariah Jean Harvey |
First Address | Henderson, NV 89015-7226 |
Second Address | Henderson, NV 89015-7226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2017 |
Last Update Date | 10/10/2017 |