Individual
MAYRA C DE ANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BASCJ
Contact information
Practice address
5641 MACETA AVE, LAS VEGAS, NV 89103-1213
(702) 767-2170
Mailing address
5641 MACETA AVE, LAS VEGAS, NV 89103-1213
(702) 767-2170
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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