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Individual

ESTELLA BLACKWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2528 GOLDENMOON ST, LAS VEGAS, NV 89108-4480
(702) 476-2445
Mailing address
2528 GOLDENMOON ST, LAS VEGAS, NV 89108-4480
(702) 476-2445

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
02/23/2011
Last updated
02/23/2011
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