Individual
DIANA MOGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6497 FIELDMOUSE AVE, LAS VEGAS, NV 89142-0984
(702) 556-0340
Mailing address
6497 FIELDMOUSE AVE, LAS VEGAS, NV 89142-0984
(702) 556-0340
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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