Individual
CHARLES LAUREN MACASINAG LORENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3312 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1829
(702) 971-2300
(702) 903-4447
Mailing address
6918 FLORIDO RD, LAS VEGAS, NV 89178-4026
(848) 459-6297
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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