Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033654173 |
---|---|
Provider Name | Veronica Cota |
First Address | North Las Vegas, NV 89086-1408 |
Second Address | North Las Vegas, NV 89086-1408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2016 |
Last Update Date | 28/12/2016 |