Individual
PATRICIA BLACKMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3620 N RANCHO DR STE 107, LAS VEGAS, NV 89130-3153
(702) 656-5683
Mailing address
3620 N RANCHO DR, STE.103, LAS VEGAS, NV 89130-3155
(702) 656-5683
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/14/2015
Last updated
09/29/2021
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