Individual
JULIO CORRALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5412 BOULDER HWY, LAS VEGAS, NV 89122-6039
(702) 291-7121
(702) 507-2534
Mailing address
1109 KING RICHARD AVE, LAS VEGAS, NV 89119-1822
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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