Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1023595907 |
---|---|
Provider Name | Sabrina Marie Sugden |
First Address | North Las Vegas, NV 89032-0861 |
Second Address | North Las Vegas, NV 89032-0861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2018 |
Last Update Date | 24/07/2018 |