Individual
DEBRA BLALARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2124 W EL CAMPO GRANDE AVE, NORTH LAS VEGAS, NV 89031-3819
(702) 768-5488
Mailing address
2124 W EL CAMPO GRANDE, NORTH LAS VEGAS, NV 89031
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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