Individual
BREANNA DEHERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
332 S DECATUR BLVD, LAS VEGAS, NV 89107-2804
(702) 665-5654
Mailing address
332 S DECATUR BLVD, LAS VEGAS, NV 89107-2804
(702) 665-5654
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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