Individual
NEVADA ESCAPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6535 N TIOGA WAY, LAS VEGAS, NV 89131-3539
(702) 289-9052
Mailing address
6535 N TIOGA WAY, LAS VEGAS, NV 89131-3539
(702) 289-9052
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NV
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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