Individual
MIKKO PANTALEON RAFANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
10663 RABBIT RIDGE CT, LAS VEGAS, NV 89183-4282
(702) 588-9894
Mailing address
10663 RABBIT RIDGE CT, LAS VEGAS, NV 89183-4282
(702) 588-9894
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-2581
NV
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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