Individual
TATIANNA STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4962 ROSWELL ST, LAS VEGAS, NV 89120-1542
(702) 800-9188
Mailing address
4962 ROSWELL ST, LAS VEGAS, NV 89120-1542
(702) 800-9188
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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