Individual
DAIRON LAZARO VILLAVICENCIO MULET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6221 FAIRBANKS RD, LAS VEGAS, NV 89103-3235
(702) 665-0710
Mailing address
6221 FAIRBANKS RD, LAS VEGAS, NV 89103-3235
(702) 665-0710
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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