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Individual

MICHELLE TACASA LAZARY USHANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
850 E. DESERT INN RD. # D11, LAS VEGAS, NV 89109
(702) 339-4593
(187) 743-5603
Mailing address
4262 BLUE DIAMOND RD. #102-297, LAS VEGAS, NV 89139
(702) 339-4593
(187) 743-5603

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/03/2011
Last updated
03/03/2011
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