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Individual

RAYNELL RICHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6725 S EASTERN AVE STE 1, LAS VEGAS, NV 89119-3949
(702) 646-2722
Mailing address
686 LOUGHTON ST, LAS VEGAS, NV 89178-1219
(702) 305-1052

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
NV
3747A0650X
Attendant Care Provider
Primary
NV
3747P1801X
Personal Care Attendant
NV
376J00000X
Homemaker
NV

Other

Enumeration date
02/23/2018
Last updated
02/23/2018
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