Individual
BLANCA MONDRAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 S DECATUR BLVD, LAS VEGAS, NV 89107-3910
(702) 998-9607
(702) 998-9648
Mailing address
2249 MIDVALE TER, HENDERSON, NV 89074-5347
(818) 540-6010
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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