Individual
DANOLA DESILUS SEVERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5350 TATES TRL, RENO, TX 75462-5903
(917) 941-0529
Mailing address
5350 TATES TRL, RENO, TX 75462-5903
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9904
AZ
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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