Individual
LISANDRA VANESSA PICANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2740 S JONES BLVD, LAS VEGAS, NV 89146-5306
(702) 248-8866
Mailing address
7605 TIERRA MONTANOSA AVE, LAS VEGAS, NV 89179-2040
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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