Individual
DONNA E UPCHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4325 W ROME BLVD APT 1179, NORTH LAS VEGAS, NV 89084-5409
(702) 280-3082
Mailing address
4325 W ROME BLVD APT 1179, NORTH LAS VEGAS, NV 89084-5409
(702) 280-3082
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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