Individual
CARMEN LUISA DIAZ RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10051 OYSTER PEARL ST, LAS VEGAS, NV 89183-7239
(702) 576-1372
Mailing address
10051 OYSTER PEARL ST, LAS VEGAS, NV 89183-7239
(702) 576-1372
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000692978
DRIVER LICENSE
NV
Enumeration date
01/30/2018
Last updated
01/30/2018
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