Individual
LORA CHARLENE VAN MATRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3430 E FLAMINGO RD, LAS VEGAS, NV 89121-5003
(702) 749-3200
(702) 749-3202
Mailing address
1092 ASPEN CLIFF DR, HENDERSON, NV 89011-2523
(740) 777-2498
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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